A 31-year-old male nurse who had rheumatic fever as a child noticed a persistent

Question

A 31-year-old male nurse who had rheumatic fever as a child noticed a persistent tachycardia and light-headedness. Upon examination, chest x-rays showed an enlarged left atrium and left ventricle. ECG analysis showed atrial fibrillation. There was also mild pulmonary congestion. Cardiac evaluation resulted in the following information: Cardiac output (CO) Blood pressure (BP) 3.4 L/min 100/58 mm Hg 6 mm Hg 44/8 mm Hg Left atrial pressure (LAP) Right ventricular pressure (RVP) Heart sounds revealed valvular regurgitation If the other A-V valve were incompetent instead of this one, would the Co. BP LAP and RVP be different? Select one or more a RVP c. CO d BP

Explanation / Answer

Answer: Optin c. Cardiac output (CO) and Option d. Blood pressure (BP)

Explanation: If the other AV valve were incompetent, Cardiac output would be decreased. Along with Cardiac output, Blood pressure will also slightly be decreased. But LAP and RVP would remain normal (So, option a and b are wrong). Hence the correct answer is option c and d.

Other information for this case study: Mitral valve is affected allowing regurgitation which is evident form the Left atrial pressure(LAP). The defect can be best heard at the left sternal edge between 4th and 5th ribs. The S1 heart sound would be loud and prolonged. Lightheadedness in the given case is due to reduced cardiac output and increased pulmonary capillary pressure resulted in mild pulmonary congestion.

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