A 42-Year-Old Man Comes to the Emergency Department Due to Acute-Onset

question 93

Multiple Choice

A 42-year-old man comes to the emergency department due to acute-onset shortness of breath.  He has no medical conditions and does not use alcohol, tobacco, or illicit drugs.  The patient works as a box handler at a warehouse and has excellent exercise tolerance.  Family history is insignificant.  Blood pressure is 98/60 mm Hg and pulse is 112/min and regular.  A short systolic murmur is heard at the apex.  Bilateral crackles are present on lung auscultation.  Bedside echocardiography reveals a flail posterior mitral leaflet due to chordal rupture and severe mitral regurgitation.  Which of the following best reflects this patient's left ventricular hemodynamics compared to the normal heart?

• A)Afterload decrease, preload decrease, ejection fraction decrease
• B)Afterload decrease, preload increase, ejection fraction increase
• C)Afterload increase, preload decrease, ejection fraction decrease
• D)Afterload increase, preload decrease, ejection fraction increase
• E)Afterload increase, preload increase, ejection fraction increase

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