Hypertension in Medicine / Internal Medicine — 66yo Man | Cardiology | SMLE Q#11338

SMLE Question #11338

Medicine / Internal Medicine Cardiology

Objective: OBJ-163

Last updated: February 2026
A 66-year-old man with hypertension and type 2 diabetes has 3 weeks of recurrent palpitations and mild shortness of breath. Cardiac examination reveals a mid-diastolic rumbling murmur at the apex. ECG shows atrial fibrillation. Transthoracic echocardiography shows severe mitral stenosis with a markedly enlarged left atrium and no visible intracardiac thrombus. What is the most appropriate next step in management to prevent thromboembolic complications?

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