USMLE Step 3 - Question 25

A 42 year old female presents to with increasing dyspnea on exertion and lower extremity edema. She denies chest pains. Her temperature is 37.0, blood pressure 150/90, heart rate 100, respirations 20, and oxygen saturation 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