CVS - Ar (5) - Quiz, Flashcards & Trivia

1. Physical examination finding in chronic aortic regurgitation

Becker sign

Corrigan pulse ("water-hammer" pulse)

Traube sign ("pistol-shot" pulse)

All of the above

Many physical examination findings have associated eponyms.
Becker sign - visible systolic pulsations of the retinal arterioles
Corrigan pulse ("water-hammer" pulse) - abrupt distention and quick collapse upon palpation of the peripheral arterial pulse
Traube sign ("pistol-shot" pulse) - booming systolic and diastolic sounds auscultated over the femoral artery.

Explanation

Many physical examination findings have associated eponyms.
Becker sign - visible systolic pulsations of the retinal arterioles
Corrigan pulse ("water-hammer" pulse) - abrupt distention and quick collapse upon palpation of the peripheral arterial pulse
Traube sign ("pistol-shot" pulse) - booming systolic and diastolic sounds auscultated over the femoral artery.

2. Not an indication for surgical replacement of the aortic valve in chronic, severe aortic regurgitation

Symptomatic patients

Asymptomatic patients with a resting left ventricular LVEF ≤ 55%

Asymptomatic patients with LV dimension > 55 mm

Aortic valve surgery is generally not indicated in asymptomatic patients with an LVEF within the reference range and less LV dilation (LV end-systolic dimension 55 mm).

Explanation

Aortic valve surgery is generally not indicated in asymptomatic patients with an LVEF within the reference range and less LV dilation (LV end-systolic dimension 55 mm).

3. The most common cause of aortic regurgitation

Bicuspid aortic valve

Rheumatic heart disease

Marfan syndrome

Whipple disease

Worldwide, rheumatic heart disease is the most common cause of aortic regurgitation. In developed nations, congenital and degenerative valve abnormalities are the most common causes.

Explanation

Worldwide, rheumatic heart disease is the most common cause of aortic regurgitation. In developed nations, congenital and degenerative valve abnormalities are the most common causes.

4. Echocardiographic finding associated with poor prognosis in chronic aortic regurgitation and may require surgical intervention

A left ventricular ejection fraction (LVEF) < 55%

An LV end-systolic dimension > 45 mm

LV hypertrophy

All of the above

LV hypertrophy may be seen as a compensatory mechanism to increase cardiac output from the early stages of aortic regurgitation and is not necessarily associated with poor long-term prognosis. An LVEF 55 mm, and an LV end-diastolic dimension

Explanation

LV hypertrophy may be seen as a compensatory mechanism to increase cardiac output from the early stages of aortic regurgitation and is not necessarily associated with poor long-term prognosis. An LVEF 55 mm, and an LV end-diastolic dimension

5. Indication for long-term vasodilator therapy for aortic regurgitation

Asymptomatic patients with moderate aortic regurgitation and ejection fraction findings within the reference range

Symptomatic surgical candidates

Nonsurgical candidates with chronic, severe aortic regurgitation

All of the above

Vasodilator therapy is indicated as long-term therapy in patients with chronic, severe aortic regurgitation and symptoms of LV dysfunction who are not candidates for surgery. Long-term vasodilator therapy is not indicated for asymptomatic patients with less than severe aortic regurgitation and ejection fraction results within the reference range; asymptomatic patients with LV dysfunction who are candidates for surgery; and symptomatic patients with less than severe LV dysfunction who are candidates for surgery.

Explanation

Vasodilator therapy is indicated as long-term therapy in patients with chronic, severe aortic regurgitation and symptoms of LV dysfunction who are not candidates for surgery. Long-term vasodilator therapy is not indicated for asymptomatic patients with less than severe aortic regurgitation and ejection fraction results within the reference range; asymptomatic patients with LV dysfunction who are candidates for surgery; and symptomatic patients with less than severe LV dysfunction who are candidates for surgery.