Tuesday, July 10, 2012

What is most likely Diagnosis?


Click one of the options to choose your answer 




A 30 year old female with no significant past medical history is 42 weeks pregnant and labor has just begun. She begins to complain of difficulty in breathing which worsens throughout delivery to the point of requiring intubation. She had never previously complained of any shortness of breath or chest pain. Her temperature is 37.0, blood pressure 90/60, heart rate 135, respirations 25, and oxygen saturation 100% on 60% FiO2 on the ventilator. Physical examination reveals diffuse pulmonary rales, a II/IV early diastolic murmur, and no lower extremity edema. Laboratory studies are normal. ECG shows sinus tachycardia and left atrial enlargement. Her chest x-ray has pulmonary edema. Which of the following is the most likely diagnosis?

Aortic Dissection
Dissection of Coronary Artery
Aortic valve Stenosis
Mitral Valve Stenosis




Please leave your comments in the Box Below.   

Subscribe via Email to Get Latest Cardiology MCQS directly to your inbox
Delivered by FeedBurner
Posted by at

5 comments:

  1. AnonymousJuly 10, 2012 at 9:47 AM

    While grossly point are correct, it is perplexing that murmur is graded 2/4. Murmur grading is from grade 1-6 NOT 1-4. Further early diastolic murmur only is unlikely in severe MS. Presence of opening snap if associated with pre-systolic accentuation can suggest presence of sinus rhythm, can this presentation be due to patient going into a fib given no mention of pre-systolic accentuation and enlarged left atrium?.

    ReplyDelete
  2. naseerJuly 10, 2012 at 3:07 PM

    mitral stenosis

    ReplyDelete
  3. Vadaliwala SuhailJuly 16, 2012 at 8:42 PM

    mitral stenosis, and buddy please tell how you will diff. On a stethoscope tht this early, mid or end systolic murmur?

    ReplyDelete
    Replies
    1. jitesharoraJuly 17, 2012 at 9:21 AM

      Thanks for the answer, Diffrentiation between the murmurs can be done with practice. Usually a systolic murmur comes between S1 and S2

      Delete
  4. AnonymousAugust 29, 2012 at 5:52 PM

    The location of the murmur? Did i miss that???

    ReplyDelete

Subscribe to: Post Comments (Atom)