CardiologySite logo
Prior Page Answer to AQ 007 Next Page

  Your answer (C) is correct!

  • The acute onset of dyspnea with a muffled S1and a brief early diastolic murmur at the base should always raise the suspicion of acute aortic regurgitation (AR).
  • The large regurgitant flow into a normal sized left ventricle (LV) precipitously raises the LV end-diastolic pressure (LVEDP) which in turn tends to close the mitral valve in early diastole and produces the muffled S1.
  • The markedly elevated LVEDP decreases the diastolic gradient across the aortic valve in late-diastole and reduces the intensity and duration of the AR murmur.

    Other relevant issues:
  • Of untreated patients with Type dissection 50% are dead within 48 hours and 90% at one month.
  • Death is usually due to rupture of the aorta into the pericardial sac or pleural space or due to acute AR with LV failure.
  • Classic findings of wide pulse pressure and bounding pulse of chronic AR are usually absent in acute cases.
  • The patients BP was normal in the right arm and 190/130 mm Hg in the left arm.
  • In the setting of early interstitial pulmonary edema, the lungs may be clear.
You may review the previous question again, if you so desire, by clicking on the left corner prior key.
Prior Page Exit Next Page
| menu | coronary angiography | cardiac auscultation | cardiology quiz |site info |
©1999-2002, A.S.M. Systems, Inc. All Rights Reserved, including design and all contents that include graphics and animations.