Cardiology Flashcards
A 80-year-old man is referred to you for evaluation of exertional chest tightness, and two episodes
of fainting.
He lives on a farm, and has been very active throughout his life, till six months ago.
During the last six months , he reports two episodes where he lost consciousness while working on
his farm.One episode left him with a bruise on his forehead , but he had no broken bones.He denied
any associated stool or urine incontinence, or any preceding feeling of dizziness or nauses, he also,
denied any preceding palpitations.
Recently, he reports onset of chest pain on exertion while working on his farm.Pain disappears once
he stops and rest for minutes.
He denies taking any medication.
On examination, Vital signs: BP=130/70 mmHg, HR=90 b /min regular, O2 saturation of 99% on
room air.
Cardiovascular examination revealed average rate and regular rhythm, with a harsh systolic murmur
heard best at the right upper sternal border with weak second heart sounds
Complete blood picture and metabolic profile are within normal limit.
The heard murmur is consistent with:
A. Valvular Aortic stenosis
B. Patent ductus arteriosus
C. Aortic regurgitation
D. Acute aortic dissection
E. Rheumatic mitral stenosis
A. Valvular Aortic stenosis
A 33-year-old woman who lives in a village in upper Egypt,presents to her physician
complaining of shortness of breath
Over the past few weeks, she has been progressively unable to walk to the farm where she
worked, without stopping to catch her breath.
For the past few nights, she has been waking up suddenly, gasping for air.
the patient says she is generally healthy and takes no medication.
Her past medical history is significant only for recurrent hospitalization when she was an
adolescent for fever, sore throat, and joint pain.
On physical examination, her blood pressure is 110/80 mm Hg, heart rate is 100/min, and
respiratory rate is 24/min.
The following signs were notice:
Jugular venous distention
diffuse wheezes and rales at both lung bases.
Oedema of her ankles bilaterally.
Heart auscultation reveals a low-pitched, diastolic murmur with an opening snap, heard
best at the apex.
What is the most common aetiology of this condition in developing countries?
A. Systemic Lupus erythematosus
B. Rheumatic Heart Disease
C. Carcinoid Heart disease
D. . Degenerative heart disease
B. Rheumatic Heart Disease
A 46 –year-old male is referred to you for evaluation of fatigue and a murmur.
Originally, five years ago, he had no symptoms when the murmur was diagnosed on
routine annual physical examination.
Over the last year, he has become more and more fatigued during his routine morning
workout as he cannot continue 15 minutes on treadmill while he was used to complete 45
minutes before he feels fatigue,
On examination:
Heart rate 75 b/min,BP 120/80
Cardiac auscultation: normal S1, soft S2, loud systolic murmur at the apex, radiating to
left axilla.
Which valvular lesion can cause this clinical finding?
A. Pulmonary valvular stenosis
B. Pulmonary valvular regurgitation
C. Aortic valve regurgitation
D. Mitral valve regurgitation
E. Mitral valve stenosis
D. Mitral valve regurgitation
A 31-year-old man who was diagnosed with (ankylosing spondylitis)
He complains of progressive shortness of breath.He has noticed rapid declinen in exercise
tolerance in the past few weeks .He complains of paroxysmal nocturnal dyspnea and
orthopnea,
On examination. Bp was 120/40, Pulse rate 110b/min
He has a diastolic murmur along the right upper sternal border.
Being 120/40, this sign in blood pressure examination is called
A. De-Musset sign
B. Water Hammer pulse.
C. Wide Pulse pressure
D. Hill ‘s sign
E. Corrigan’s sign,
C. Wide Pulse pressure
