USMLE Step 2 - Question 45

A 42-year-old female presents with increasing dyspnea on exertion and lower extremity edema. She denies chest pain. Her temperature is 37.0, BP is 150/90 mm Hg, heart rate is 100 bpm, respirations are 20, and oxygen saturation is 92% on room air. Physical examination reveals normal breath sounds, elevated jugular venous pressure, a III/VI holosystolic murmur at the apex occurring after a mid-systolic click, an S3 heart sound, and 1+ pitting lower extremity edema. Which of the following is the best treatment at this time?

A. ACE inhibition

B. Beta-blockade

C. Mitral valve repair

D. Mitral valve replacement

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