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Old 06-04-2011
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Heart Which investigation to use for this mitral valve issue?

A 40-year-old woman is successfully treated for acute pulmonary edema in the emergency department. Ten years ago she had a porcine xenograft bioprosthetic mitral valve replacement.
Physical examination shows left ventricular enlargement, a grade 2/6 holosystolic murmur, a grade 1/6 diastolic rumble at the apex, an S3, and bibasilar crackles. Chest radiography shows pulmonary venous congestion. Electrocardiography shows sinus tachycardia and left ventricular hypertrophy.
Which of the following studies is most likely to establish the diagnosis?
( A ) Radionuclide ventriculography
( B ) Cardiac fluoroscopy
( C ) Transesophageal echocardiography with Doppler
( D ) Right and left heart catheterization
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Old 06-06-2011
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C) (a little trivia: the mitral valve was the first structure to be identified by echocardiography)
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Cardiology-, Internal-Medicine-, Step-3-Questions

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