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John is a 35-year-old nurse who had rheumatic fever as a child. He noticed a persistent tachycardia and light-headedness. Chest x-rays showed an enlarged left atrium and left ventricle. ECG analysis showed atrial fibrillation and mild pulmonary congestion. Cardiac evaluation resulted in the following information:

   

Cardiac output (CO)


3.4 L/min

 

Blood pressure (BP)


100/58 mm Hg

 

Left atrial pressure (LAP)


16 mm Hg

 

Right ventricular pressure (RVP)


44/8 mm Hg

 

Heart sounds revealed valvular regurgitation.


q1/Deduce which A-V valve is incompetent, thus allowing the regurgitation.?

q2/Using anatomical terms, describe the location at which this valvular disorder could best be heard.

q3/Which heart sound would be pronounced and lengthened?

q4/If the other AV valve were incompetent instead of this one, would the CO, BP, LAP, and RVP be different? If so, how?

q5/What are the causes of the tachycardia, light-headedness, and mild pulmonary congestion?

    • 8 years ago
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