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Posted: December 20th, 2021

John is a 35-year-old nurse who had rheumatic fever as a child

John is a 35-year-old nurse who had rheumatic fever as a child. He noticed a persistent tachycardia and light-headedness. Chest x-rays showed an enlarged left atrium and left ventricle. ECG analysis showed atrial fibrillation and mild pulmonary congestion. Cardiac Assessment resulted in the following information:

Cardiac output (CO)

3.4 L/min

Blood pressure (BP)

100/58 mm Hg

Left atrial pressure (LAP)

16 mm Hg

Right ventricular pressure (RVP)

44/8 mm Hg

Heart sounds revealed valvular regurgitation.

q1/Deduce which A-V valve is incompetent, thus allowing the regurgitation.?

q2/Using anatomical terms, describe the location at which this valvular disorder could best be heard.

q3/Which heart sound would be pronounced and lengthened?

q4/If the other AV valve were incompetent instead of this one, would the CO, BP, LAP, and RVP be different? If so, how?

q5/What are the causes of the tachycardia, light-headedness, and mild pulmonary congestion?

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