USMLE Forum Archives - USMLE Step 1 - 4243
4243
babbu5508 - 02-22-11 04:09
On a routine physical examination for medical insurance, a midsystolic ejection murmur is detected in the pulmonic area of a 35-year-old female executive. The cardiac examination also revealed a prominent right ventricular cardiac impulse and wide and fixed splitting of the second heart sound. An ECG showed a right axis deviation and chest x-ray showed enlargement of the right ventricle and atrium. Which of the following is the most likely diagnosis
Options:
A. Aortic stenosis
B. Atrial septal defect
C. Mitral regurgitation
D. Mitral stenosis
E. Pulmonary valve stenosis
babbu5508 - 02-22-11 04:09
On a routine physical examination for medical insurance, a midsystolic ejection murmur is detected in the pulmonic area of a 35-year-old female executive. The cardiac examination also revealed a prominent right ventricular cardiac impulse and wide and fixed splitting of the second heart sound. An ECG showed a right axis deviation and chest x-ray showed enlargement of the right ventricle and atrium. Which of the following is the most likely diagnosis
Options:
A. Aortic stenosis
B. Atrial septal defect
C. Mitral regurgitation
D. Mitral stenosis
E. Pulmonary valve stenosis
The correct answer and explanation will be available after you answer.
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#2
Re: 4243
babbu5508 - 03-15-11 09:47 The correct answer is B. The classic findings in atrial septal defect are a prominent right ventricular cardiac impulse, a systolic ejection murmur heard in the pulmonic area and along the left sternal border, and fixed splitting of the second heart sound. These findings are due to an abnormal
left-to-right shunt through the defect, creating a volume overload on the right side.
#3
Re: 4243 sudha2015 - 03-15-11 13:44 On a routine physical examination for medical insurance, a midsystolic ejection murmur is detected in the pulmonic area of a 35-year-old female executive. The cardiac examination also revealed a prominent right ventricular cardiac impulse and wide and fixed splitting of the second heart sound. An ECG showed a right axis deviation and chest x-ray showed enlargement of the right ventricle and atrium. Which of the following is the most likely diagnosis
b
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