Examkin

Soru

Zorluk: ZorCardiovascular System

Match each dynamic auscultation or hemodynamic finding to the most likely underlying cardiovascular pathology.

  • A harsh systolic murmur that decreases in intensity during a sustained handgrip maneuverHypertrophic obstructive cardiomyopathy
  • A systolic murmur that becomes prolonged and moves closer to S1 during the strain phase of the Valsalva maneuverMitral valve prolapse
  • An early diastolic decrescendo murmur that decreases in intensity following administration of amyl nitriteAortic regurgitation
  • A low-pitched diastolic rumble with a shorter A2-to-extra sound interval as disease severity worsensMitral stenosis

Cevap

The correct matches align specific hemodynamic responses and dynamic auscultation findings to their respective valvular and structural pathologies based on changes in preload and afterload.
Each cardiovascular pathology is correctly matched based on standard physiological principles governing how maneuvers that alter preload and afterload affect murmur intensity, duration, and timing.

Adım Adım Çözüm

1
Analyze the effect of sustained handgrip on the harsh systolic murmur.
The murmur intensity decreases.
Handgrip increases afterload, which increases left ventricular volume and physically opens the narrowed left ventricular outflow tract, characteristic of Hypertrophic Obstructive Cardiomyopathy.
2
Analyze the effect of the Valsalva strain phase on the systolic murmur.
The murmur moves closer to S1 and prolongs.
Valsalva decreases preload and reduces left ventricular volume, causing earlier prolapse of the redundant leaflets seen in Mitral Valve Prolapse.
3
Analyze the effect of amyl nitrite on the early diastolic murmur.
The murmur intensity decreases.
Amyl nitrite decreases afterload, which reduces the backward pressure gradient pushing blood retrogradely across an incompetent valve in Aortic Regurgitation.
4
Analyze the A2-to-extra sound interval in the low-pitched diastolic rumble.
A shorter interval indicates greater disease severity.
Higher left atrial pressure in severe Mitral Stenosis forces the valve open earlier in diastole, shortening the A2-Opening Snap interval.

Anahtar Kavram

Dynamic auscultation and hemodynamic responses of cardiac murmurs
Tahmini Süre:1m 30s
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Konular

Cardiovascular System

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