A 48 year old man presents with palpitations and awareness of a forceful heartbeat. He recently recovered from infective endocarditis. Blood pressure is 162/54 mm Hg. Examination shows head bobbing, bounding peripheral pulses, and a high pitched early diastolic decrescendo murmur heard best along the left sternal border when leaning forward in held expiration. Which of the following best explains this patient's widened pulse pressure?
- A)Reduced diastolic arterial pressure due to backflow into the left ventricleGABARITO
- B)Delayed closure of the pulmonic valve
- C)Impaired right ventricular filling during diastole
- D)Left to right shunting across the atrial septum
- E)Fixed obstruction to left ventricular outflow during systole
Explicação
This patient has aortic regurgitation, suggested by the early diastolic decrescendo murmur, bounding pulses, and wide pulse pressure. During diastole, blood leaks from the aorta back into the left ventricle, lowering diastolic pressure and increasing stroke vo... Ver explicação completa e trilha adaptativa →