A 45-year-old female with a history of rheumatic fever presents with the complaint of exercise intolerance. Physical examination reveals jugular venous distention, peripheral edema, and hepatomegaly. Auscultation of the chest reveals a pancystolic murmur along the left lower sternal border with radiation to the right sternum, and xiphoid and increased jugular venous pressures. Chest X-ray reveals prominent right heart border and dilatation of the superior vena cava. Electrocardiogram reveals right axis deviation. Based on the presentation and physical examination, which of the following is the proper diagnosis?

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The material on the PANCE and PANRE is organized by the NCCPA into two dimensions, as indicated in the content blueprint for the examination. - Organ systems and the diseases, disorders and medical assessments physician assistants encounter within those systems; and - The knowledge and skills physician assistants should exhibit when confronted with those diseases, disorders and assessments. Medical Content Categories % Allocation: Cardiovascular System 13% Dermatologic System 5% Endocrine System 7% Eyes, Ears, Nose, and Throat 7% Gastrointestinal System/Nutrition 9% Genitourinary... Show more

A 45-year-old female with a history of rheumatic fever presents with the complaint of exercise intolerance. Physical examination reveals jugular venous distention, peripheral edema, and hepatomegaly. Auscultation of the chest reveals a pancystolic murmur along the left lower sternal border with radiation to the right sternum, and xiphoid and increased jugular venous pressures. Chest X-ray reveals prominent right heart border and dilatation of the superior vena cava. Electrocardiogram reveals right axis deviation. Based on the presentation and physical examination, which of the following is the proper diagnosis?






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