A 54-year-old man, with a 20-year history of chronic obstructive lung disease, has a heave that is palpable at the lower left sternal border at the third, fourth, and fifth intercostal spaces. Which of the following best explains the etiology of that heave?
سؤال مجاني 9 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: D. Right ventricular hypertrophy
A heave at the left lower sternal border (parasternal) is the sign of right ventricular hypertrophy. Long-standing COPD causes hypoxic pulmonary vasoconstriction and pulmonary hypertension, leading to RVH and cor pulmonale. Aortic stenosis gives a sustained (heaving) apex, not a parasternal heave; pericardial effusion makes the precordium quiet.
ليش كل خيار صح أو غلط
-
A
ليش غلط
Aortic stenosis raises left ventricular afterload (left-sided failure); it does not explain a right-ventricular heave.
✓ (Y4)-(M B) HF.pdf · p. 3 -
B
ليش غلط
Left-sided failure gives a displaced apex beat and S3; the right ventricular heave belongs to right-sided signs with pulmonary hypertension.
✓ (Y4)-(M B) HF.pdf · p. 3 -
C
ليش غلط
Fluid compressing the heart (tamponade) makes the apical impulse difficult to locate or non-palpable, not a heave.
✓ Cardiology 🫀.pdf · p. 44 -
D
ليش صح
A right ventricular heave is found with pulmonary hypertension, which long-standing COPD causes (right ventricular hypertrophy, cor pulmonale).
✓ (Y4)-(M B) HF.pdf · p. 3
- المصدر
- COPD.pdf · p. 4
(Y4)-(M B) HF.pdf · p. 3 - المحاضرة
- Heart Failure · Cardiology · Module B
- ظهر في
- Cardio bank · Respi bank