CVS - Ar (5)
- 1.
The most common cause of aortic regurgitation
- A.
Bicuspid aortic valve
- B.
Rheumatic heart disease
- C.
Marfan syndrome
- D.
Whipple disease
Correct Answer
B. Rheumatic heart diseaseExplanation
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.Rate this question:
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- 2.
Echocardiographic finding associated with poor prognosis in chronic aortic regurgitation and may require surgical intervention
- A.
A left ventricular ejection fraction (LVEF) < 55%
- B.
An LV end-systolic dimension > 45 mm
- C.
LV hypertrophy
- D.
All of the above
Correct Answer
A. A left ventricular ejection fraction (LVEF) < 55%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%, an LV end-systolic dimension > 55 mm, and an LV end-diastolic dimension < 75 mm are signs of poor prognosis and usually require surgical evaluation.Rate this question:
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- 3.
Indication for long-term vasodilator therapy for aortic regurgitation
- A.
Asymptomatic patients with moderate aortic regurgitation and ejection fraction findings within the reference range
- B.
Symptomatic surgical candidates
- C.
Nonsurgical candidates with chronic, severe aortic regurgitation
- D.
All of the above
Correct Answer
C. Nonsurgical candidates with chronic, severe aortic regurgitationExplanation
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.Rate this question:
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- 4.
Not an indication for surgical replacement of the aortic valve in chronic, severe aortic regurgitation
- A.
Symptomatic patients
- B.
Asymptomatic patients with a resting left ventricular LVEF ≤ 55%
- C.
Asymptomatic patients with ejection fraction results within the reference range and LV end-systolic dimension < 50 mm or LV end-diastolic dilation < 70 mm
- D.
Asymptomatic patients with LV dimension > 55 mm
Correct Answer
C. Asymptomatic patients with ejection fraction results within the reference range and LV end-systolic dimension < 50 mm or LV end-diastolic dilation < 70 mmExplanation
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 < 50 mm, LV end-diastolic dimension < 70 mm). Aortic valve surgery is recommended in patients with chronic, severe aortic regurgitation if they are symptomatic; if they are asymptomatic, with a resting EF ≤ 55%; or they are asymptomatic and have LV dilation (LV end-systolic dimension > 55 mm).Rate this question:
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- 5.
Physical examination finding in chronic aortic regurgitation
- A.
Becker sign
- B.
Corrigan pulse ("water-hammer" pulse)
- C.
Traube sign ("pistol-shot" pulse)
- D.
All of the above
Correct Answer
D. All of the aboveExplanation
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.Rate this question:
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Mar 20, 2023Quiz Edited by
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Dec 31, 2018Quiz Created by
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