A 62-year-old man with hypertension. On auscultation: a diastolic decrescendo murmur was heard at the left lower sternal area, decreased by Valsalva maneuver and standing up. What is your diagnosis?
سؤال مجاني 2 من 10 اليوم · اشترك وكمّل بدون حد
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الإجابة: B. Aortic regurgitation
A decrescendo diastolic murmur along the left sternal border is aortic regurgitation. Valsalva and standing reduce venous return and so soften almost all murmurs; only HOCM and MVP get louder/longer with these manoeuvres. Aortic stenosis is a systolic crescendo-decrescendo murmur, and HOCM/MVP are systolic murmurs that increase with Valsalva.
ليش كل خيار صح أو غلط
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A
ليش غلط
Aortic stenosis is a systolic problem: ejection click plus crescendo-decrescendo murmur at the right upper sternal border radiating to the carotids, not a diastolic decrescendo murmur at the left sternal edge.
✓ 8• Heart Sounds & Murmurs [Notes].pdf · p. 5 -
B
ليش صح
Aortic regurgitation gives a high-pitched decrescendo early diastolic murmur, heard best along the left sternal border (Erb point), as blood leaks from the aorta back into the LV.
✓ CARDIOLOGY- VHD+IE.pdf · p. 10 -
C
ليش غلط
Valsalva or standing lowers almost all murmurs but increases the HCM murmur. Here the murmur decreased, so it does not behave like HCM.
✓ 8• Heart Sounds & Murmurs [Notes].pdf · p. 8 -
D
ليش غلط
In mitral valve prolapse, Valsalva or standing makes the click come earlier and the murmur longer, rather than quieter.
✓ 8• Heart Sounds & Murmurs [Notes].pdf · p. 8
- المصدر
- CARDIOLOGY- VHD+IE.pdf · p. 10
8• Heart Sounds & Murmurs [Notes].pdf · p. 8 - المحاضرة
- Valvular Heart Disease · Cardiology · Module B
- ظهر في
- MED43 ♀ Compre · MED42 ♂ EOM B