Question

John is a 35-year-old nurse who had rheumatic fever as a child. He noticed a persistent tachycardia and light-headedness. Chest x-rays showed an enlarged left atrium and left ventricle. ECG analysis showed atrial fibrillation and mild pulmonary congestion. Cardiac evaluation resulted in the following information: Cardiac output (CO) 3.4 L/min Blood pressure (BP) 100/58 mm Hg Left atrial pressure (LAP) 16 mm Hg Right ventricular pressure (RVP) 44/8 mm Hg Heart sounds revealed valvular regurgitation. 1) Deduce which A-V valve is incompetent, thus allowing the regurgitation. 2) Using anatomical terms, describe the location at which this valvular disorder could best be heard. 3) Which heart sound would be pronounced and lengthened? 4) If the other AV valve were incompetent instead of this one, would the CO, BP, LAP, and RVP be different? If so how? 5) What are the causes of the tachycardia, light-headedness, and mild

Answer 1

ANS)

1) The A-V valve that is uncouth, permitting the spewing forth, is the mitral valve

2) This valvular issue could best be heard at the left midclavicular line at the fifth intercostal space.

3) The principal heart sound would be articulated and extended for mitral ineptitude.

4) On the off chance that the tricuspid valve was clumsy rather than the mitral valve, the LAP and RVP would be extraordinary. They both would be ordinary or close typical.

5) The tachycardia is a reflex reaction (thoughtful) to the brought down foundational pulse. The wooziness is from the diminished circulatory strain (100/58). The gentle pneumonic clog is because of spewing forth of blood through the mitral valve from the left ventricle into the left chamber amid left ventricular withdrawal. This "invert stream" through the inept mitral valve lifts the left atrial weight and expands the pneumonic slender weight, bringing about liquid aggregation in the lungs (aspiratory clog).