A 52-Year-Old Man Comes to the Office with Concerns About

question 117

Multiple Choice

A 52-year-old man comes to the office with concerns about a "heart problem."  Three years ago, the patient was told during a routine physical examination that he had a heart murmur.  Currently, he has no specific complaints, but he mentions that he has become tired more easily in the past year.  He has no chest pain or lower extremity swelling or significant medical history.  The patient was healthy as a child and received all his childhood vaccinations.  Blood pressure is 145/90 mm Hg and pulse is 80/min and regular.  Physical examination reveals a holosystolic murmur best heard at the apex of the heart that radiates to the axilla.  The lungs are clear on auscultation and abdominal examination is unremarkable.  Which of the following is the best indicator of the severity of this patient's valve disease?

• A)Presence of audible S3
• B)Presence of audible S4
• C)Presence of mid-systolic click
• D)S2-to-opening snap time interval
• E)Splitting of S2 accentuated by inspiration

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Definitions:

Potential Impact

A possible effect or outcome that a specific action or event might have on something or someone.

Direct Correlation

A relationship between two variables where an increase or decrease in one variable directly causes the same change in the second variable.

Complexity

The degree to which a project or task is complicated, often influenced by the number of interrelated components, variability, and uncertainty.

Positive Correlation

A relationship between two variables where an increase in one variable is associated with an increase in the other.