what is ur answer - klmklm

[ArchivalUser]

right ventricle has most o 2 auration 73%.how it could be?only way ventriclar septal defect.ANSWER B

[ArchivalUser]

hi klmklm,
Are u gonna post the answer???? i THOUGHT i WAS LATE WITH POSTING WITH ANSWERS...U BEAT ME BY A FULL DAY...

[ArchivalUser]

(E) Papillary muscle rupture
Educational Objective: Recognize acute mitral regurgitation due to papillary muscle rupture and determine the most appropriate course of action.

Localized transmural myocardial infarction can lead to papillary muscle rupture with acute severe mitral regurgitation. Papillary muscle rupture is a rare complication that develops in less than 0.1% of patients with myocardial infarctions. It most often occurs several days after the initial infarction. Complete rupture of the papillary muscle is rapidly fatal; most patients who present clinically have partial rupture involving only one head of a papillary muscle. Papillary muscle dysfunction, without frank rupture, can also result in severe mitral regurgitation after myocardial infarction. Recognition is vital because survival 24 hours after rupture is less than 25% with medical therapy. Even with placement of an intra-aortic counterpulsation balloon followed by emergency mitral valve replacement, survival is only 50%.

In addition to the findings on right heart catheterization, echocardiography provides accurate and rapid bedside diagnosis of the mechanical complications of acute myocardial infarction. If transthoracic imaging is not diagnostic, transesophageal echocardiography should be considered. Myocardial rupture can also occur in the free wall of the ventricle with resultant pericardial tamponade (recognized by equalization of intracardiac diastolic pressures) or can occur in the ventricular septum (recognized by an increase in right ventricular oxygen saturation). Left ventricular diastolic dysfunction commonly accompanies myocardial ischemia but rarely has an acute presentation. Although the symptoms of recurrent myocardial infarction with left ventricular systolic dysfunction may be similar, electrocardiographic changes are absent and a murmur is present.

[ArchivalUser]

i would like to go with papillary muscle rupture