Cardiology: percutaneous balloon mitral valvotomy: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Cardiology: percutaneous balloon mitral valvotomy

Sample item

A 30-year-old woman with rheumatic severe mitral stenosis, NYHA III symptoms, pliable valve, Wilkins score 7 and no left atrial thrombus or significant MR is being planned for intervention. What is the best treatment?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Percutaneous balloon mitral valvotomy

Symptomatic severe rheumatic MS with favourable anatomy (Wilkins score 8 or less), no LA thrombus and no more than mild MR is treated by percutaneous balloon valvotomy. Surgery is reserved for unsuitable anatomy. Transoesophageal echo excludes left atrial appendage thrombus.

Option by option

  • A. Mitral valve replacement with a mechanical valve

    Replacement is for unsuitable anatomy, not first choice here.

  • B. Mitral valve repair via sternotomy

    Open repair is not preferred when PBMV is feasible.

  • C. Percutaneous balloon mitral valvotomy (correct)

    Correct. PBMV is first choice with favourable valve morphology.

  • D. Medical therapy only with diuretics

    Medical therapy alone does not relieve the mechanical obstruction.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is C, Percutaneous balloon mitral valvotomy. Symptomatic severe rheumatic MS with favourable anatomy (Wilkins score 8 or less), no LA thrombus and no more than mild MR is treated by percutaneous balloon valvotomy.

Why is "Mitral valve replacement with a mechanical valve" not the answer?

Replacement is for unsuitable anatomy, not first choice here.

Why is "Mitral valve repair via sternotomy" not the answer?

Open repair is not preferred when PBMV is feasible.

Why is "Medical therapy only with diuretics" not the answer?

Medical therapy alone does not relieve the mechanical obstruction.

What concept does this question test?

It tests Cardiology: percutaneous balloon mitral valvotomy in General Medicine. Surgery is reserved for unsuitable anatomy. Transoesophageal echo excludes left atrial appendage thrombus.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Cardiology: percutaneous balloon mitral valvotomy?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.