This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Medicine
A new systolic murmur after Acute myocardial infarction may be due to all of the following Except: 
Select and explain. 
A. Complete hea block, B. Rupture of Interventricular septum, C. Papillary muscle dysfunction, D. Ischemic cardiomyopathy
A: Complete hea block
Answer: A: Complete hea block 
Explanation: Answer is A (Complete hea block) Complete hea block iv not a cause for new onset systolic murmur after Acute _Myocardial Infarction. Cause of new systolic murmur after Acute Myocardial infarction Papillary muscle dysfunction/rupture (causing severe mitral regurgitation) Rupture of interventricular septum Right ventricular infarction and tricuspid regurgitation Free wall rupture Left ventricular outflow tract obstruction Note: Ischemic cardiomyopathy is defined as dilated cardiomyopathy in a subject with history of MI. This may lead to papillary muscle dysfunction and hence produce a new onset systolic murmur.