A 54-year-old woman arrives at the office complaining of exertional dyspnea and fatigue. The patient experiences shortness of breath while walking two blocks from her home to a store. She also has difficulty breathing at night and sleeps with two or three pillows to prop herself up. She has had palpitations on occasion but no chest pain. The patient does not regularly take medications and does not use tobacco, alcohol, or illegal drugs. She is scheduled for a left heart catheterization after an initial evaluation, the results of which are shown below. Which of the following is the most likely diagnosis?

Question

A 54-year-old woman arrives at the office complaining of exertional dyspnea and fatigue. The patient experiences shortness of breath while walking two blocks from her home to a store. She also has difficulty breathing at night and sleeps with two or three pillows to prop herself up. She has had palpitations on occasion but no chest pain. The patient does not regularly take medications and does not use tobacco, alcohol, or illegal drugs. She is scheduled for a left heart catheterization after an initial evaluation, the results of which are shown below.  Which of the following is the most likely diagnosis?

Quizplus · Accepted Answer

Eductional Objective: The time of passive filling of the left atrium corresponds to left ventricular systole (atrial diastole). During this period, mitral valve regurgitation causes markedly elevated left atrial pressure, resulting in the characteristic early and large V wave on left atrial pressure tracing.

A 54-Year-Old Woman Arrives at the Office Complaining of Exertional