A 34-Year-Old Asian Female Is Hospitalized with Progressive Exertional Dyspnea

A 34-year-old Asian female is hospitalized with progressive exertional dyspnea, lower extremity edema and cough.  She also describes frequent nocturnal episodes of breathlessness and recent hoarseness.  She does not use tobacco, alcohol or drugs.  Auscultation reveals loud first and second heart sounds and a mid-diastolic rumble best heard at the cardiac apex.  This patient's hoarseness is most likely caused by:

A) Laryngeal edema
B) Impaired arterial supply
C) Nerve impingement
D) Epithelial sloughing
E) Vocal cord polyps

Correct Answer:

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