A 35-year-old woman presents to the emergency department with acute-onset dyspnea at rest and orthopnea that awakened her from sleep. She reports a history of acute rheumatic fever at age 10 that was treated with penicillin. On physical examination, vital signs show tachycardia at 102/min and blood pressure of 128/82 mmHg. Cardiac auscultation reveals a loud S1, an early diastolic opening snap, and a low-pitched, rumbling diastolic murmur best appreciated at the apex when the patient is positioned in the left lateral decubitus position. The murmur does not increase with Valsalva. Chest radiography demonstrates bilateral pulmonary edema, and the left heart border shows straightening of the normal concave contour. Which of the following valvular lesions is most likely responsible for this patient's presentation?

1. A)Aortic regurgitation with acute decompensated heart failure
2. B)Mitral regurgitation secondary to left ventricular dilation
3. C)Aortic stenosis with secondary pulmonary edema
4. D)Mitral stenosisGABARITO
5. E)Tricuspid stenosis with right ventricular dysfunction