Review Question - QID 108826

A 58-year-old female presents with a 2-month history of intermittent non-bloody diarrhea. She reports that she has been following a raw food diet for 6 months to help her lose weight. The patient’s medical history is significant for anxiety which is treated with fluvoxamine and osteopenia. She reports that her mother has lactose intolerance and has recently been diagnosed with osteoporosis. The patient denies any tobacco or alcohol use. When asked about recent travel, she reports she returned 3 months ago from a mission trip in Uganda. The patient’s temperature is 99°F (37.2°C), blood pressure is 130/78 mmHg, pulse is 70/min, and respirations are 14/min with an oxygen saturation of 98% O2 on room air. On physical exam, a new-onset systolic ejection murmur is noted that is best appreciated at the left 2nd intercostal space. Which of the following complications is associated with the most likely cause of this patient's symptoms?