Cedrick
Forum Fanatic
Topics: 322
Posts: 1,975
|
a 78 year old man with syncope feel heaviness in his chest with exertion and breathlenessness when lying down
a crecendo/decrecendo systolic murmur is heard best at the second right intercostal space with radiation to the carotid arteries
Which of the following measurements of the left ventricular
and aortic pressure is most likely to be found on cardiac catheterization ?
a.-100/10 left ventricular 150/90 aortic
b.-100/18 left ventricular 100/50
c.-150/10 left ventricular 150/80
d.-150/18left ventricula 100/50
e.-150/18 left ventri 150/80
Thanks for the help
|
| Cedrick
Forum Fanatic
Topics: 322
Posts: 1,975
|
CHF ?
Well I think the hemodianamic in this case is E
but don't know for sure
|
| study_ing
Forum Fanatic
Topics: 180
Posts: 2,511
|
the presentaion i think is classical of Aortic stenosis
the murmur and its radiation suggest AS
the ans wud pble be D
___________________
If you yourself are at peace, then there is at least some peace in the world.
|
| study_ing
Forum Fanatic
Topics: 180
Posts: 2,511
|
we have to figure out first what it is
the crescendo decrescendo murmur with radiation to carotids seems AS. AS is most often due to age related sclerosis .
hence we wud look for an answer in which the sytolic pressures in the ventricle are higher than in the aorta. D is the only matching option.
good luck
___________________
If you yourself are at peace, then there is at least some peace in the world.
|
| Cedrick
Forum Fanatic
Topics: 322
Posts: 1,975
|
Maybe,maybe
Thanks
|
| Cedrick
Forum Fanatic
Topics: 322
Posts: 1,975
|
I mean I agree is aortic stenosis,and probable mitral regurgitation
so I see nummber and I get confused
but thanks for the follow up
|
| study_ing
Forum Fanatic
Topics: 180
Posts: 2,511
|
not MR...MR has a pansystolic murmur with radiation to the axilla.
also second right intercostal space would point more towards athe aortic area
i hate murmurs. the numbers arent that bad
___________________
If you yourself are at peace, then there is at least some peace in the world.
|
| xwxf
Forum Senior
Topics: 16
Posts: 71
|
Should be D
Why? One concept is important: LV systolic pressure= aortic systolic pressure at normal condition when AV is fully open.
In this patient, there is a AV stenosis. The above formula becomes LVSP=ASP+ pressure on AV. So, we are looking for a choice with higher LVSP than ASP. It's D.
|
| xwxf
Forum Senior
Topics: 16
Posts: 71
|
one more thing, if it's MS, we would expect higher LASP than LVDP.
The key to cardiac catheter question is to look at LV. LVSP=aortic SP; LVDP=LASP
|
| docswapna
Forum Senior
Topics: 61
Posts: 229
|
sorry xwyf. u got it wrong. explanation by studying is perfect.
|
|
| |
| | | | | | | | | | |
