drk1980
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found this pathophys Q at anthr forum...
A 54-year-old woman presents with a pansystolic murmur along the lower left sternal border radiating rightward to the midclavicular line. The murmur is medium pitched, has a blowing quality, and increases slightly on inspiration. An S3 is audible along the lower left sternal border. Jugular venous pressure is elevated, and a prominent "v" wave is visible. Which of the following is the most likely etiology of the S3?
A. Aortic stenosis
B. Mitral regurgitation
C. Pulmonic stenosis
D. Tricuspid regurgitation
E. Volume overloaded left ventricle
F. Volume overloaded right ventricle
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| Doc2378
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F.
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| robin082006
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I go with F too.
S3 right ventricular gallop is heard at the left lower sternal border. Inspiration increases its intensity.
While S3 left ventricular gallop is at the apex of the heard. Holding breath and excercise increase the intensity of S3 right gallop.
Edited by robin082006 on 12/25/05 - 12:47 PM
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| Geroo
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I go with F .
but what u think the diagnosis is?tricusped rigurge?
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| drk1980
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yup! thts typical of a tricuspid regurg murmur. clincher being 'inc intensity on inspiration'. S3, no doubt is during the rapid filling of a volume overloaded ventricle. Due to tricuspid involmnt, we knw S3 is from the right side.
Apparently, rt vent failure and dilation, wth enlargemnt of the tricuspid valve orifice, is the M.C.C. of tricuspid regurgitation and is often secondary to pulmonary hypertension or left ventricular failure.
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