A 62-Year-Old Man with a Long History of Hypertension Comes

question 187

Multiple Choice

A 62-year-old man with a long history of hypertension comes to the clinic for a routine physical examination.  Blood pressure is 150/90 mm Hg and pulse is 74/min and regular.  Cardiac auscultation reveals a low-frequency, presystolic sound that immediately precedes S1 and is best heard during expiration when the patient is lying on his left side.  Chest x-ray reveals extensive calcification around the mitral and aortic valves.  Which of the following is the most likely explanation for the additional heart sound?

• A)Increased flow velocity through the aortic valve
• B)Increased stiffness of the left ventricular wall
• C)Rapid passive filling of the ventricles
• D)Restricted motion of the aortic valve cusps
• E)Systolic anterior motion of the mitral valve

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Definitions:

Replenished

The process of refilling or restoring inventory, supplies, or funds to their previous level or to a desired level of capacity.

Miscellaneous Expense

Small, often irregular costs that don't fit into a specific category within a company's financial statements.

Federal Reserve

The central banking system of the United States, responsible for monetary policy, banking supervision, and financial services.

Parties to a Check

The individuals or entities involved in a check transaction, including the drawer, payee, and drawee.