32-year-old female presented with dyspnea, edema, and malaise. She complains of breathlessness at rest. She also had episode of paroxysmal nocturnal dyspnea. She noticed bilateral ankle swelling a week ago they become progressively worse. She is non- smoker and non-alcoholic. Her past medical history is not significant. She is not taking any medications. her vitals: HR:90 bpm, BP:140/66 mmHg, RR:14 bpm. Examination shows venous distention, rapidly raising carotid pulse with sudden collapse and bilateral crepitation. Cardiac auscultation showed S3 gallop and high-pitched blowing early diastolic decrescendo murmur best heard at the le 3rd intercostal space, leaning forward, and holding her breath in expiration intensifies the murmur. Based on these findings what's the most likely diagnosis for this patient?
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الإجابة: A. Aortic Regurgitation
Rapidly rising, collapsing (water-hammer) pulse, wide pulse pressure (140/66), an S3, and a high-pitched blowing early diastolic decrescendo murmur at the left 3rd ICS, louder leaning forward in expiration = aortic regurgitation with left heart failure. AS is a systolic ejection murmur. MS is a low-pitched apical rumble.
ليش كل خيار صح أو غلط
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A
ليش صح
Aortic regurgitation: a rapidly rising and collapsing (Corrigan) pulse, S3 and a high-pitched blowing decrescendo early diastolic murmur at the left 3rd-4th intercostal space.
✓ CARDIOLOGY- VHD+IE.pdf · p. 10 -
B
ليش غلط
Aortic stenosis gives a harsh crescendo-decrescendo systolic murmur, not a diastolic decrescendo murmur with a collapsing pulse.
✓ Step Up To Medicine 6th (Valvular Heart Disease).pdf · p. 3 -
C
ليش غلط
Mitral stenosis gives an opening snap and a low-pitched diastolic rumble with a loud S1, not a high-pitched blowing decrescendo murmur at the left sternal border.
✓ Step Up To Medicine 6th (Valvular Heart Disease).pdf · p. 1 -
D
ليش غلط
Atrial fibrillation is a rhythm diagnosis (irregularly irregular rhythm, no P wave on ECG), not a valve lesion producing a diastolic decrescendo murmur.
✓ Cardiology 🫀.pdf · p. 21
- المصدر
- CARDIOLOGY- VHD+IE.pdf · p. 10
- المحاضرة
- Valvular Heart Disease · Cardiology · Module B
- ظهر في
- Cardio bank