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)
This physical sign suggests 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
Revision Tip
Revise severity of mitral regurgitation
ACES for PACES page 215
Revise mitral regurgitation KEYS
to SUCCESS in Medicine page 120-122
