A 52-year-old woman with hypertension and atrial fibrillation presents with dyspnea and fatigue. Cardiac examination reveals an irregularly irregular rhythm and a holosystolic murmur at the apex radiating to the axilla. Echocardiography shows a dilated left ventricle with markedly reduced ejection fraction and secondary mitral regurgitation. Which of the following best describes the etiology of her mitral regurgitation?
- A)Papillary muscle rupture from myocardial infarction
- B)Primary mitral valve leaflet pathology with structural damage
- C)Rheumatic mitral valve fusion and thickening
- D)Infective endocarditis with vegetation on the valve
- E)Geometric annular dilation and leaflet tethering from LV enlargementGABARITO
Explicação
Secondary (functional) mitral regurgitation results from geometric changes in the left ventricle and mitral annulus. LV dilation increases annular diameter and causes leaflet tethering by papillary muscle displacement, preventing adequate coaptation. The valve... Ver explicação completa e trilha adaptativa →