WBR278

Author	[[PageAuthor::Sapan Patel M.B.B.S]]
Exam Type	ExamType::USMLE Step 3
Main Category	MainCategory::Community Medical Health Center, MainCategory::Primary Care Office
Sub Category	SubCategory::Cardiovascular
Prompt	[[Prompt::A 68-year-old male is seen in the office for recurrent chest pain. He reports that he is getting substernal chest pain, without radiation, when he goes for a walk. The pain resolves with 12–15 minutes of rest. He has never had pain at rest. He has no other cardiac complaints and his review of systems is otherwise negative. He has an unremarkable medical history and takes only a baby aspirin a day. On examination, his blood pressure is 130/68, pulse 86, and respiratory rate 14. His cardiac examination is notable for a harsh, 3/6 systolic ejection murmur along the sternal border that radiates to the carotid arteries. His carotid pulsation is noted to rise slowly and is small and sustained. His lungs are clear. The remainder of his examination is normal. Which of the following would be the most appropriate test to order?]]
Answer A	AnswerA::Cardiac catheterization
Answer A Explanation	AnswerAExp::
Answer B	AnswerB::Electrophysiologic studies
Answer B Explanation	AnswerBExp::
Answer C	AnswerC::Exercise stress test
Answer C Explanation	AnswerCExp::
Answer D	AnswerD::Echocardiogram
Answer D Explanation	AnswerDExp::
Answer E	AnswerE::24-hour Holter monitor
Answer E Explanation	AnswerEExp::
Right Answer	RightAnswer::D
Explanation	[[Explanation:: Educational Objective: References: ]]
Approved	Approved::Yes
Keyword	WBRKeyword::Aortic stenosis
Linked Question	Linked::
Order in Linked Questions	LinkedOrder::