No Known Medical Problems in Medicine / Internal Medicine — 54yo Woman | Cardiology | SMLE Q#1074
SMLE Question #1074
Medicine / Internal Medicine
Cardiology
Last updated: February 2026
A 54-year-old woman with no known medical problems attends an outpatient cardiology clinic for a routine checkup. She denies dyspnea, chest pain, palpitations, syncope, orthopnea, or leg swelling and exercises without limitation. Cardiac auscultation reveals a grade 4/6 holosystolic murmur at the apex radiating to the left axilla; S1 and S2 are normal, with no S3 or S4. Lungs are clear and there is no peripheral edema. What is the most appropriate next test to confirm the suspected diagnosis of primary mitral regurgitation?
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