Heart Failure & Valvular Diseases Q 50 - Gyan Darpan : Learning Portal
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Wednesday 27 April 2022

Heart Failure & Valvular Diseases Q 50

After an anterior wall myocardial infarction, which of the following problems is indicated by auscultation of crackles in the lungs?
     A. Left-sided heart failure
     B. Pulmonic valve malfunction
     C. Right-sided heart failure
     D. Tricuspid valve malfunction

Correct Answer: A. Left-sided heart failure

The left ventricle is responsible for most of the cardiac output. An anterior wall MI may result in a decrease in left ventricular function. When the left ventricle doesn’t function properly, resulting in left-sided heart failure, fluid accumulates in the interstitial and alveolar spaces in the lungs and causes crackles.

Option B: Pulmonic stenosis is the main murmur auscultated in infants with Tetralogy of Fallot. It is described as a crescendo-decrescendo systolic ejection murmur heard loudest at the upper left sternal border. Onset is typically from congenital causes but may be seen in chronic rheumatic heart disease.
Option C: Coarse crackles are lower-pitched and moist-sounding, like pouring water out of a bottle or ripping open velcro. This lung sound is often a sign of adult respiratory distress syndrome (ARDS), early congestive heart failure, asthma and pulmonary edema.
Option D: Tricuspid valve malfunction causes right-sided heart failure. This diastolic murmur is best heard at the lower left sternal border. Typical causes include infective endocarditis, seen in intravenous drug users, and carcinoid syndrome. Prolonged tricuspid stenosis may lead to right atrial enlargement and arrhythmias.

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