52-year-old man with diabetes is referred to you for the evaluation of chest pain and dyspnea. His m

Discussion in 'Step 3' started by samuel, Dec 13, 2014.

  1. samuel

    samuel New Member

    52-year-old man with diabetes is referred to you for the evaluation of chest pain and dyspnea. His
    medications include glyburide and aspirin. He is afebrile, has a blood pressure of 130/78 mm Hg, heart rate of 72/min, and respiratory rate of 18 /min. His lungs are clear bilaterally. He has a prominent, nondisplaced apical impulse and a I/VI, late peaking systolic ejection murmur at the cardiac base. An echocardiogram result from the referring physician shows a preserved ejection fraction, mild-moderate concentric hypertrophy without systolic wall motion abnormalities, and an aortic valve area of 0.6 cm2. The most likely cause of the patient's chest pain and dyspnea is
    A. congestive heart failure
    B. critical aortic stenosis
    C. hypertensive cardiomyopathy
    D. idiopathic hypertrophic subaortic stenosis
    E. ischemic heart disease

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