khorshid
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another easy approach without going into much detail: it is heard on the apex with the "bell" so we're done to low pitched sounds like S3 and S4. then S3 is an early diastolic sound, S4 is a late diastolic sound. this one was late , So:S4
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| young_doc
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Another BIG clue is that (without getting into the physiology) Hypertension leads initially to S3, and with chronic hypertension, eventually to S4.
S4. since our patient has a history of hypertension for 10 years.
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| tn1kinobe
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Straight out of bates you guys...8th edition, pgs 250 and 278. The left lateral decubitus position allows for left ventricle wall to be closer to chest wall. Bell brings out low pitch sounds like S3 and S4. Late diastole clue tells us it's S4, not S3.
Answer is I) S4
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| ssrpk
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thank God!
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| klimt
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good job people!
so it's I
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| ashfaque
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answer A,
aortic insufficiency > pulse presuure is wide > diastolic murmur in left lateral position of functional mitral stenosis( austin flint murmur) produce due to compression of ant leaflet of mitral valve due to high pressure in aorta .
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| ing
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I. left side position, I guess it's easier for right side of blood to pump out, then left side of the heart got volume over loaded, plus late diasto murmur, ---- S4
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| vallia
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S4 then
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