A 46-Year-Old Man with a 30-Pack-Year Smoking History Develops Right

A 46-year-old man with a 30-pack-year smoking history develops right leg pain and swelling after returning from an overseas trip.  He is diagnosed with a lower extremity deep venous thrombosis and is started on intravenous heparin.  Shortly after being hospitalized, he develops right-sided weakness and facial droop.  CT scan of the head reveals a left middle cerebral artery stroke.  Which of the following physical examination findings is most likely to be present in this patient?

A) Diastolic decrescendo-type murmur that decreases following amyl nitrite inhalation
B) Ejection-type systolic murmur that increases on standing
C) Presystolic murmur that disappears with atrial fibrillation
D) Midsystolic click that occurs earlier with inspiration
E) Wide splitting of S2 that does not change with respiration

Correct Answer:

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