By M.D. Luthra Atul, JPS Sawhney
This booklet presents postgraduate trainees with 50 genuine scientific cardiology instances. Divided into fourteen sections, a number of instances are provided below each one classification overlaying a variety of issues of the cardiac procedure, together with congenital center illnesses, aortic valve ailments, pulmonary ailments, ECG abnormalities, cardiac arrhythmias, coronary artery disorder and masses extra. starting with a quick background and findings according to actual exam, each one case then comprises analytical dialogue on bedside investigations and suggestions for remedy. Authored via a acknowledged professional within the box, this useful e-book is extremely illustrated with echocardiographic, radiographic and electrocardiographic facts. Key issues offers 50 actual medical cardiology instances Covers quite a few issues of the cardiac approach Authored through regarded heart specialist contains greater than 217 photographs, illustrations and tables
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Additional resources for 50 cases in clinical cardiology : a problem solving approach
CLINICAL DISCUSSION From the history and physical examination, this young woman in all probability had rheumatic heart disease with mitral valve stenosis (Fig. 1). 1: Mitral valve stenosis 26 Section 2 Mitral Valve Diseases since the mitral valve leaflets are distant from each other at the end of diastole and snap together loudly. Other reasons for a loud S1 are sinus tachycardia and a short P-R interval, where the diastole is short. The mid-diastolic murmur of mitral stenosis (MS) is best heard with the patient in the left lateral decubitus position, using the stethoscope bell.
There was no evidence of pharyngo-tonsillitis, swollen joints or petechial spots over the skin, eyes or finger-tips. The apex beat was tapping in nature with a left parasternal heave. The S1 was loud and the P2 was also accentuated. A low-pitched mid-diastolic rumbling murmur was heard over the cardiac apex. The murmur was preceded by an opening snap and accentuated just before systole. There were scattered rhonchi and crepts over the lung fields. CLINICAL DISCUSSION From the history and physical examination, this young woman in all probability had rheumatic heart disease with mitral valve stenosis (Fig.
She also denied having had recurrent sorethroat, joint pains or any prolonged febrile illness during her school days. On examination, the patient was comfortable, relaxed and not dyspneic. There was no tremor of the fingers, visible goiter or eye-signs of Grave’s disease. The JVP was raised 5 cm above the angle of Louis and showed large v waves with a prominent y descent. The pulse was regular, fair in volume, at a rate of 84 beats/min. and the BP was 130/80 mm Hg. On examining the abdomen, there were visible epigastric pulsations, with the liver edge 6 cm below the right costal margin and pulsatile; no ascites was demonstrable.