During a history examination, a patient tells the nurse, The ...

[james0929]

During a history examination, a patient tells the nurse, The cardiologist says I have a leaking valve.  The nurse documents that the patient has a history of
 
  a. acute mitral regurgitation.
  b. aortic insufficiency.
  c. chronic mitral regurgitation.
  d. pericardial friction rub.

Question 2

A 66-year-old patient is admitted to the critical care unit with a diagnosis of acute inferior MI
 
  A 12-lead electrocardiogram (ECG) is done to validate the area of infarction. For the above patient, which leads on the ECG would correlate with an inferior wall MI?
 
  a. II, III, aVF
  b. V5 to V6, I, aVL
  c. V2 to V4
  d. V1 to V2

[briezy]

Answer to Question 1

B
Aortic insufficiency is an incompetent aortic valve. If the valve cusps do not maintain this seal, the sound of blood flowing back into the left ventricle during diastole is heard as a decrescendo, high-pitched, blowing murmur. A pericardial friction rub is a sound that can occur within 2 to 7 days after a myocardial infarction. The friction rub results from pericardial inflammation (pericarditis). Classically, a pericardial friction rub is a grating or scratching sound that is both systolic and diastolic, corresponding to cardiac motion within the pericardial sac. Acute mitral regurgitation occurs when the ventricle contracts during systole and a jet of blood is sent in a retrograde manner to the left atrium, causing a sudden increase in left atrial pressure, acute pulmonary edema, and low CO and leading to cardiogenic shock. Chronic mitral regurgitation is auscultated in the mitral area and occurs during systole. It is high pitched and blowing, although the pitch and intensity vary, depending on the degree of regurgitation. As mitral regurgitation progresses, the murmur radiates more widely.

Answer to Question 2

A
Inferior infarctions are manifested by electrocardiographi c (ECG) changes in leads II, III, and aVF. Lateral wall infarctions are manifested by ECG changes in leads V5 to V6, I, and aVL. Anterior wall infarctions are manifested by ECG changes in leads V2 to V4 . Posterior wall infarctions are manifested by ECG changes in leads V1 to V2 .

[james0929]

TYSM

[daiying98]

Excellent