One week ago, a 72-year-old woman had an episode in which she became dis oriented, had...

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One week ago, a 72-year-old woman had an episode in which she became dis oriented, had difficulty speaking, andhad weakness on the right side of the body. On physical examination, she is afebrile with pulse of 68/min, respirations of 15/min, and blood pressure of 130/85 mm Hg. On auscultation, the lungs are clear, the heart rate is irregular, and there is a midsystolic click. An echocardiogram shows nodular deposits with the density of calcium around the mitral valve. One leaflet of the mitral valve appears to balloon upward. The ejection fraction is estimated to be 55% Laboratory findings show Na*, 141 mmol/L; K', 4.1 mmol/L; CI, 98 mmol/L; CO2, 25 mmol/L; glucose, 77 mg/dL; creatinine, 0.8 mg/dL; calcium, 8.1 mg/dL; and phosphorus, 3.5 mg/dL. Which of the following is the most likely diagnosis? (A) Carcinoid heart disease (B) Hyperparathyroidis m (C) Infective endocarditis (D) Infiltrative cardiomyopathy (E) Mitral annular calcification (F) Rheumatic heart disease (G) Senile calcific stenosis One week ago, a 72-year-old woman had an episode in which she became dis oriented, had difficulty speaking, andhad weakness on the right side of the body. On physical examination, she is afebrile with pulse of 68/min, respirations of 15/min, and blood pressure of 130/85 mm Hg. On auscultation, the lungs are clear, the heart rate is irregular, and there is a midsystolic click. An echocardiogram shows nodular deposits with the density of calcium around the mitral valve. One leaflet of the mitral valve appears to balloon upward. The ejection fraction is estimated to be 55% Laboratory findings show Na*, 141 mmol/L; K', 4.1 mmol/L; CI, 98 mmol/L; CO2, 25 mmol/L; glucose, 77 mg/dL; creatinine, 0.8 mg/dL; calcium, 8.1 mg/dL; and phosphorus, 3.5 mg/dL. Which of the following is the most likely diagnosis? (A) Carcinoid heart disease (B) Hyperparathyroidis m (C) Infective endocarditis (D) Infiltrative cardiomyopathy (E) Mitral annular calcification (F) Rheumatic heart disease (G) Senile calcific stenosis

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