A 17-year-old develops a tightening sensation in his mid sternum during exercise

Question Number 0084

Question:
A 17-year-old develops a tightening sensation in his mid sternum during exercise. On examination the pulse rate is 180/minute, the respiratory rate is 38/minute, and the blood pressure is 120/90 mm Hg. You hear a suprasternal notch thrill, an apical click, and a 3/6 ejection murmur at the right upper sternal border. The most likely diagnosis is

a) mitral insufficiency
b) aortic stenosis
c) pericarditis
d) tricuspid incompetence
e) costochondritic pain.


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