A 75-year-old patient presents to the ER after a sudden syncopal episode. He is again alert and in retrospect describes occasional substernal chest pressure and shortness of breath on exertion. His lungs have a few bibasilar rales, and his blood pressure is 110/80. On cardiac auscultation, the classic finding you expect to hear is:
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الإجابة: A. A harsh systolic crescendo-decrescendo murmur heard best at the upper right sternal border
An elderly patient with syncope, exertional chest pressure and dyspnea has the classic AS triad (SAD). The expected finding is a harsh crescendo-decrescendo systolic murmur at the upper right sternal border radiating to the carotids. A diastolic decrescendo murmur is AR, a holosystolic apical murmur is MR, and a mid-systolic click is MVP.
ليش كل خيار صح أو غلط
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A
ليش صح
Syncope, exertional chest pain and dyspnea are the classic aortic stenosis triad, and AS gives a harsh crescendo-decrescendo systolic murmur at the upper sternal border radiating to the carotids.
✓ HEART VALVE DISEASE.pdf · p. 3 -
B
ليش غلط
A diastolic decrescendo murmur at the left sternal border is aortic regurgitation, which comes with a widened pulse pressure and a water-hammer pulse, not the AS picture.
✓ Step Up To Medicine 6th (Valvular Heart Disease).pdf · p. 5 -
C
ليش غلط
A holosystolic apical murmur radiating to the back or clavicular area is mitral regurgitation, which presents with exertional dyspnea, PND and orthopnea rather than syncope with angina.
✓ Step Up To Medicine 6th (Valvular Heart Disease).pdf · p. 6 -
D
ليش غلط
A mid-systolic click is mitral valve prolapse: redundant leaflet tissue prolapses into the left atrium in systole. Most patients are asymptomatic, so it does not fit syncope with exertional angina.
✓ Step Up To Medicine 6th (Valvular Heart Disease).pdf · p. 8
- المصدر
- HEART VALVE DISEASE.pdf · p. 3
- المحاضرة
- Valvular Heart Disease · Cardiology · Module B
- ظهر في
- Cardio bank