* forever, gunny.al.. i missed this one
		#531356
	pursuit - 09/06/10 16:03
	A 22-year-old female student is evaluated for a rapid heartbeat that builds over the course of the day and is not associated with chest pain or shortness of breath. She adds that she has been drinking a lot of coffee lately to finish term papers and study for finals. She is one of the best players on an intramural soccer team. The patient’s medical history is significant for tetralogy of Fallot repair that she underwent at age 2 years. She received a patch closure of the ventricular septal defect and a transannular patch to relieve pulmonic stenosis. She last saw her pediatric cardiologist 4 years ago, who told her everything was “OK.” On physical examination, she is afebrile, her blood pressure is 110/60 mm Hg, pulse is 92/min, and respiration rate is 16/min. Estimated central venous pressure is 8 cm H2O. She has a mild right ventricular heave, a single S2, and a soft diastolic murmur at the base that increases in intensity with inspiration. She has clear lungs and no peripheral edema. The results of a hematocrit and thyroid function tests are within normal limits. An echocardiogram shows a repaired tetralogy of Fallot and a mildly enlarged aorta and no residual ventricular septal defect. Left ventricular systolic function is normal. The right ventricle is moderately enlarged with normal systolic function. The pulmonic valve is not easily viewed, but regurgitation is present. Which of the following is the most appropriate management option? A-Cardiac magnetic resonance imaging B-Chest CT C-Counsel her to avoid pregnancy D-Endocarditis prophylaxis for dental procedures E-Reassurance I always pick the wrong one when I have to choose between 2 optionssssss urgggggggg what to do?
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