A 53-Year-Old Man Comes to the Emergency Department Due to Fever

question 226

Multiple Choice

A 53-year-old man comes to the emergency department due to fever and progressive weakness over the last 2 weeks.  Yesterday, he also developed shortness of breath.  The patient emigrated from Eastern Europe 2 years ago and says he was diagnosed with "heart disease" in the distant past, but he does not recall any details.  He does not use tobacco, alcohol, or illicit drugs.  Despite receiving appropriate medical care, the patient expires during hospitalization.  On autopsy, gross examination of his heart shows large, friable masses on the mitral valve with extensive destruction of cuspal tissue. Which of the following is the most likely predisposing factor for this patient's presenting condition?

• A)Myocardial hypertrophy
• B)Myocardial thinning and fibrosis
• C)Pericardial effusion
• D)Rupture of chordae tendineae
• E)Valvular inflammation and scarring

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