Thank you for participating in this week’s USMLE quiz question! The answer is (D) Echocardiography
A 72-year-old woman comes to the physician because of a 2-month history of painless swelling of both ankles. She also reports shortness of breath with exertion and when lying down. She has been awakened from sleep by shortness of breath. She has not had chest pain. Her pulse is 96/min and regular, respirations are 24/min, and blood pressure is 128/76 mm Hg. Jugular venous pressure is 15 cm H2O. Pulmonary examination shows crackles at both lung bases. Cardiac examination shows a regular rhythm and a soft S3. A grade 3/6 holosystolic murmur is heard best at the apex, radiating to the axilla. There is 2+ pitting edema of the lower legs and ankles.
Which of the following is most likely to confirm the diagnosis?
(A) Measurement of serum troponin I concentration
(B) ECG
© Exercise stress test
(D) Echocardiography
(E) Pulmonary artery catheterization