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q____________? - sarim - Printable Version

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q____________? - sarim - ArchivalUser - 04-12-2011

A 60 y/o man on the cardiology ward presents with a hx of myocardial Infarction.ECG shows a broaden QRS complex, no R wave in V1, and a tall, wide R wave in V6.Splitting of the S2 heart sound increases upon expiration and decreases upon inspiration.What underlying pathology would explain these clinical findings ?

A-AV nodal re-entry
B-Damage to the left bundle branch
C-Damage to the right bundle branch
D- First degree AV block
E- Pre-excitation syndrome


0 - ArchivalUser - 04-12-2011

B is the answer


0 - ArchivalUser - 04-12-2011

C..?


0 - ArchivalUser - 04-12-2011

B.


0 - ArchivalUser - 04-12-2011

bb. I think because increases during expiration--> left-sided


0 - ArchivalUser - 04-12-2011

yes,expiration causes inc.S2.....so left heart side problem,Sad


0 - ArchivalUser - 04-12-2011

very well Smile

What happen to S2 splitting in "Mitral Regurgitation" ? and how ?


0 - ArchivalUser - 04-12-2011

ouch, I always have hard time with Qs like that. I would assume that there is a delay in a closure of aortic valves.


0 - ArchivalUser - 04-12-2011

so, the closure of pulmonic valves would be first, followed by aortic valves closure.


0 - ArchivalUser - 04-12-2011

I think there is no direct change on S2 splitting in MR...because S2 splitting due to the closure of Aortic and Pulmonic valve and if there is stenosis of these 2 valves.....the S2 spliting changes significantly.