Answer BOF 2.16

 

   

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BOF: 2.16

A 60-year-old female presents with a history of fatigue. On examination she has a regular pulse, rate 80 beats per minute, jerky in character. The JVP is not elevated her apex beat is displaced and thrusting in nature. On auscultation there is a 3rd heart sound and there is a pan systolic murmur at the apex radiating to the axilla. Lung bases are clear.

In this patient which of the following physical signs suggests that the mitral regurgitation is severe?

a)      Jerky pulse

b)    Thrusting apex

c)      3rd heart sound

d)      Pan systolic murmur at the apex

e)      Murmur radiating to the axilla

Answer:

c)

The physical signs suggest that the patient has mitral regurgitation . The clinical signs that suggest severity of mitral regurgitation are the size of the left ventricle and the presence of a 3rd heart sound. A soft first heart sound also suggests severe mitral regurgitation.

Mitral Regurgitation

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