Cardiac

Question 1

Systolic murmur with wide pulse pressure and pulmonary oedema
This history is highly suggestive of..

Answer 1

aortic regurgitation which can be either due to valve disease or root disease.
Valve disease is when there is pathology of the valve leaflets themselves, and root is where dilation of the root results in insufficient functioning.

valve causes: age, calcified, bicuspid, connective tissue disorders, infective endocarditis.
root: connective tissue disorders, hypertension, turners, aortic dissection, bicuspid valve.

Associated signs:
- quinckes sign (nail bed pulsations)
- corrigans sign (bounding carotid pulse, characterized by a rapid systolic rise and a rapid diastolic collapse)
- de mussets sign (head bobbing)

surgical replacement indicated if severe and symptomatic or asympomatic but severe LV systolic dysfunction