USMLE Step 2 - Question 12

A 36 year old female with no past medical history presents to her primary care office a complaint of chest pains for the past few months. She states that intermiittently she has a feeling that she is going to die and develops severe chest pains and palpitations. The pain is substernal, pressure-like, and radiating to her left arm. It can last for minutes or hours at a time. Her blood pressure is 120/80, heart rate 80, and respirations 20. Physical examination reveals normal lung sounds, no murmurs, and a mid-systolic click that moves to early systole with standing from a squatting position. Her ECG is normal. Which of the following is the most likely diagnosis?

A. Mitral valve regurgitation

B. Myocardial ischemia

C. Mitral valve prolapse

D. Mitral valve stenosis