A 34-Year-Old Woman Is Being Evaluated for Fatigue and Progressive

A 34-year-old woman is being evaluated for fatigue and progressive exertional dyspnea.  She goes mountain biking with friends a few times a month and recently noticed that she has to stop and rest more frequently when traveling uphill.  The patient has no significant medical history and takes no medications.  She occasionally drinks alcohol but does not use tobacco or illicit drugs.  Her father died of a myocardial infarction at age 72.  Lung auscultation is normal.  An echocardiogram shows an enlarged coronary sinus.  Which of the following is the most likely cause of the observed finding in this patient?

A) Aortic dissection
B) Coronary artery disease
C) Hypertrophic cardiomyopathy
D) Pericardial effusion
E) Pulmonary hypertension

Correct Answer:

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