q 3 - demi

[ArchivalUser]

A 52-year-old woman from India is referred to your office by her dentist. She states that she was told as a teenager that she had a "heart murmur." On further questioning, she complains of having episodes of shortness of breath that worsens on exertion. Physical examination is significant for a widely split S2 and an additional diastolic sound followed by a mid-diastolic rumbling murmur. This is best heard at the fourth intercostal space at the left sternal border. The chest x-ray shows straightening of the left heart border. What is appropriate as the initial treatment of this patient?

(A) Balloon valvotomy
(B) Digoxin
© Surgical repair
(D) ACE inhibitors
(E) Diuretics

[ArchivalUser]

EE

[ArchivalUser]

aa

[ArchivalUser]

EE