cardio q - kiranraja

[ArchivalUser]

A 14-year-old girl is found to have a late apical
systolic murmur preceded by a click during a
screening physical examination for participation
in high school sports. The rest of the examination
is unremarkable. Echocardiography
show superior displacement of the mitral
leaflets of > 2 mm during systole into the left
atrium, with a thickness of 8 mm. In addition,
she states that her father also has some type of
heart œmurmur, but she knows nothing else
about it. Which of the following would be appropriate
for management at this time?
(A) Digoxin
(B) Instruct the patient to avoid all forms of
strenuous activity
© Metoprolol
(d) Mitral valve replacement
(E) Prophylactic antibiotics for dental procedures

[ArchivalUser]

e?

[ArchivalUser]

_ BB or EE.

go with EEE

[ArchivalUser]

ee

[ArchivalUser]

EE

[ArchivalUser]

MVP - but Endocarditis prophylaxis should be given to only severe cases

[ArchivalUser]

The correct answer is E.

Mitral valve prolapse
(MVP) occurs when the leaflets of the mitral
valve bulge backward into the left atrium during
systole, resulting in a characteristic mid- to
late-systolic murmur, often associated with a
preceding click. It is caused by an underlying
structural abnormality of the mitral valve, and
seems to be more common in adolescent girls.
Antibiotic prophylaxis shoud be considered in
patients with a mid-systolic click and latesystolic
mitral regurgitation murmur, including
those with increased leaflet thickening or redundancy,
left atrial enlargement, and left
ventricular dilatation, even in the absence of
correlated clinical findings. Due to the transient
bacteremia following dental procedures,
prophylactic antibiotics are recommended
since the prolapsed valve can serve as a nidus
for colonization.

Answer A is incorrect. Digoxin does not play
a role in the management of MVP.

Answer B is incorrect. MVP, unlike HCM,
does not have an increased risk of sudden
death and therefore does not require restriction
of activity.

Answer C is incorrect. β-Blockers are not indicated
since the patient is asymptomatic and
without a history of known cardiac disease.

Answer D is incorrect. Surgical valvular replacement
is reserved for more advanced cases