04-19-2016, 06:36 PM
A previously healthy 42 y/o female comes to the physician because of a 6 month history of shortness of breath with moderate exertion and pulsatile tinnitus in her left ear. She has had to decrease her daily running from 40 mins to 20 mins at a slower pace. She takes no medications. Her last menstrual period was 5 weeks ago. She is sexually active and uses a diaphragm for contraception. She appears well. Her blood pressure is 130/60 mm HG, pulse is 96/min, and respirations are 16/min. A bruit is heard over the left ear. The lungs are clear to auscultation. A grade 2/6, early systolic murmur is heard at the left sternal border. The cardiac apex is laterally displaced and enlarged. Peripheral pulses are bounding. An ECG shows no abnormalities except for left ventricular hypertrophy. Echocardiography shows a left ventricular ejection fraction of 50% and an increased left ventricular end-diastolic volume. Which of the following is the most likely diagnosis?
A) Aortic Stenosis
B) Arteriovenous malformation
C) Hypertrophic Cardiomyopathy
D) Osteitis deformans (Paget's Disease)
E) Pregnancy
F) Vitamin B1 (thiamine) deficiency
A) Aortic Stenosis
B) Arteriovenous malformation
C) Hypertrophic Cardiomyopathy
D) Osteitis deformans (Paget's Disease)
E) Pregnancy
F) Vitamin B1 (thiamine) deficiency