Mitral Regurgitation Case #1 - Question #1

A 55-year-old male presents with acute onset chest pain and diaphoresis. His ECG reveals an acute myocardial infarction, and emergency intervention is performed. He is treated medically and discharged home in stable condition. Five days later, he is found nearly unresponsive and brought to the ED. His temperature is 95.0, blood pressure 70/30 mm Hg, heart rate 120 beats per minute and respirations 30 per minute. No murmur is appreciated, and examination otherwise reveals rales throughout both lung fields. Repeat angiography shows a patent stent and hyperdynamic left ventricular systolic function, but there are large V waves in the pulmonary capillary wedge pressure tracing. Which of the following is the most likely diagnosis?

A. Acute ventricular septal defect

B. Free wall rupture causing cardiac tamponade

C. Acute mitral regurgitation

D. Aortic rupture