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Medicine

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Cardiology

Question
25 out of 30
 

Graham steels murmur is heard in? (LQ)



A AR
B MVP
C PS
D PR

Ans. D

PR

Pulmonary stenosis

Causes: Usually congenital Q(Turner's syndrome, Noonan's syndrome, William's syndrome, Fallot's tetralogy, rubella).

Pulmonary valve is the least common valve involved in RHD (AIIMS May’08)


Acquired causes:

1. RHD

2. Carcinoid syndrome.

Symptoms:Dyspnoea; fatigue; oedema, ascites.

Signs:

1. Dysmorphic facies Q (seen in congenital cases)

2. Prominent a wave in JVP; heave.

3. In mild stenosis, there is an ejection click, ejection systolic murmur (which radiates to the left shoulder); widely split In severe stenosis, the murmur becomes longer and obscures A2.

4. P2 becomes softer and may be inaudible (single S2) Q.


Tests:


ECG:RAD, p-pulmonale, RVH, RBBB.

CXR:post-stenotic dilatation of pulmonary artery

Oligemic lung fields

Right atrial enlargement.

Treatment: Pulmonary valvuloplasty or valvotomy.


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