A 27-year-old woman comes to the office due to exertional dyspnea over the past 3 months. The patient initially had shortness of breath during exercise but now becomes dyspneic with routine activities. She has had no cough, fever, or leg swelling but has noticed increased fatigue over this time. The patient does not use tobacco, alcohol, or illicit drugs. Vital signs are within normal limits. Physical examination reveals a loud pulmonic component of S2 but is otherwise unremarkable. Chest x-ray shows clear lungs. Which of the following is the most likely cause of this patient's findings?

Question

A 27-year-old woman comes to the office due to exertional dyspnea over the past 3 months.  The patient initially had shortness of breath during exercise but now becomes dyspneic with routine activities.  She has had no cough, fever, or leg swelling but has noticed increased fatigue over this time.  The patient does not use tobacco, alcohol, or illicit drugs.  Vital signs are within normal limits.  Physical examination reveals a loud pulmonic component of S2 but is otherwise unremarkable.  Chest x-ray shows clear lungs.  Which of the following is the most likely cause of this patient's findings?

Quizplus · Accepted Answer

Eductional Objective: Pulmonary hypertension can be recognized on physical examination by a loud pulmonic component of S2 and an accentuated, palpable impulse at the left sternal border (left parasternal lift due to right ventricular heave).

A 27-Year-Old Woman Comes to the Office Due to Exertional