A 28-Year-Old Professional Endurance Athlete Comes to the Office After

A 28-year-old professional endurance athlete comes to the office after his team physician detected a heart murmur.  The patient has no symptoms and has no exercise limitations.  Medical history is nonsignificant.  Blood pressure is 110/66 mm Hg and pulse is 54/min.  Physical examination shows a soft systolic murmur best heard at the left second intercostal space in the supine position.  The murmur disappears when the patient is upright but reappears after brief exercise.  Which of the following cardiovascular adaptations best explains this patient's finding?

A) Decreased pulmonary vascular capacitance
B) Decreased vagal tone
C) Increased stroke volume
D) Increased systemic vascular resistance
E) Increased ventricular wall thickness

Correct Answer:

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