Acute rheumatic fever and rheumatic heart disease Quiz: Ace Your Exams

Get ready to dominate your medical and nursing exams by using our dynamic quizzes to elevate your knowledge and increase your confidence. Whether you're gearing up for the USMLE®, COMLEX®, or your next in-class assessment, Osmosis quizzes tackle key topics in pathology, diagnostics, and treatment approaches. By honing in on clinical readiness and decision-making, we make sure the knowledge you gain empowers you both in the classroom and in real-world practice. Jump in and supercharge your exam prep!

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A 16-year-old boy presents to his primary care provider’s office for his annual physical examination. The patient is doing well in 10th grade and is on his high school’s baseball team. Past medical history is significant for a tonsillectomy due to recurrent illnesses and episodes of pharyngitis when he was younger. Temperature is 37°C (98.6°F), blood pressure is 117/68 mmHg, pulse is 116/min, respiratory rate is 22/min, and oxygen saturation is 98% on room air.  Physical examination demonstrates a new 2/6 holosystolic murmur best heard at the apex. Pulmonary examination is normal. Lower extremity exam is within normal limits. The patient is referred to cardiology and a transthoracic echocardiogram which demonstrates pathologic mitral regurgitation along with chordal thickening and restricted leaflet motion. There is no pericardial effusion. Ejection fraction is estimated to be 65%. Which of the following is the best next step in treatment?

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