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  #1  
Old 08-27-2012
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Heart Paradoxical movement of left ventricle

64 yr old male admitted to hospital because of chest pain, ECG and cardiac enzymes confirm a non ST segment MI. Echo: shows a apex of left ventricle bulges out during systole and inward during diastole. which of following is the most likely location of disease process?

a) aortic valve
b) mitral valve
c) circumflex artery
d) left anterior descending artery
e) tricuspid valve
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  #2  
Old 08-27-2012
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A... Aortic valve ???
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  #3  
Old 08-27-2012
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Classic Aortic Insuficiency. A....
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Old 08-27-2012
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me too would like to go with A) aortic valve...
i think problem is with AV node..
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  #5  
Old 08-28-2012
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b) mitral valve
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Old 08-29-2012
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Default answer....

pathophysio QBANK Q:
Quote:
Originally Posted by riya_rai84 View Post
64yr old male admited to hospital because of chest pain,ECG and cardiac enzymes confirm a non ST segment MI. Echo: shows a apex of left ventricle bulges out during systole and inward during diastole.which of folowing is the most likely location of disease process?


d)left anterior descending artery
i have also marked aortic valve but
In explanation simply it was writen that "paradoxical movement" in heart occurs due to involvement of left anterior descending artery..
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Quote:
Originally Posted by riya_rai84 View Post
pathophysio QBANK Q:


i have also marked aortic valve but
In explanation simply it was writen that "paradoxical movement" in heart occurs due to involvement of left anterior descending artery..
but, if you get anything/anywhere about the explanation..plz post it here....thanq
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Old 08-29-2012
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Quote:
Originally Posted by venky2600 View Post
but, if you get anything/anywhere about the explanation..plz post it here....thanq
http://www.echoincontext.com/int2/skillI2_05.asp

OR

http://circ.ahajournals.org/content/49/3/423.full.pdf
page 426 (on right side 3rd paragraph)
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Quote:
Originally Posted by riya_rai84 View Post
pathophysio QBANK Q:


i have also marked aortic valve but
In explanation simply it was writen that "paradoxical movement" in heart occurs due to involvement of left anterior descending artery..
Hey where did you get this question,... from which Qbank...
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Quote:
Originally Posted by obinocle View Post
Hey where did you get this question,... from which Qbank...
kaptest USMLE STEP1 QBANK (online version)
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Old 08-29-2012
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Default LAD

Left ant descending artery.
resulting from myocardial infarction due to blockade of LAD. One of the complications/sequelae of MI. Results in loss of muscle contractility in the area of supply and hence the paradoxical movement.
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  #12  
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Quote:
Originally Posted by DrPKR View Post
Left ant descending artery.
resulting from myocardial infarction due to blockade of LAD. One of the complications/sequelae of MI. Results in loss of muscle contractility in the area of supply and hence the paradoxical movement.
http://www.ncbi.nlm.nih.gov/pubmed/6969197

30 coronary artery disease (CAD) patients (pts) were studied by echocardiography before and after left anterior descending (LAD) coronary bypass graft in order to evaluate left ventricular (LV) behaviour.

Echocardiograms were recorded early pre- and post-operatively:

The following parameters were considered: left ventricular end diastolic dimension (LVDD), right ventricular diastolic dimension (RVDD), diastolic thickness, systolic thickening and motion of the interventricular septum (IVS) and of the LV posterior wall (LVPW).

We conclude that: 1) IVS paradoxical motion is frequently recorded by echo shortly after coronary bypass graft surgery. 2) In most pts it is accompanied by an increased excursion of LVPW, probably compensatory in origin.

Both tend to normalize within few months in most of the subjects.
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Paradoxical movement of the left ventricle= buzz word for ventricular aneurysm. It's in Goljan, under complications of MI. Also, we know that anterior left ventricle territory is supplied by LAD, which can lead to aneurysm and this striking finding.
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Quote:
Originally Posted by DrPKR View Post
Left ant descending artery.
resulting from myocardial infarction due to blockade of LAD. One of the complications/sequelae of MI. Results in loss of muscle contractility in the area of supply and hence the paradoxical movement.

This is one of those questions where the answer is really easy but u just can't get over the fact that something else is happening
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Quote:
Originally Posted by debs View Post
This is one of those questions where the answer is really easy but u just can't get over the fact that something else is happening
ha ha! Story of our lives!
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Old 10-06-2012
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Quote:
Originally Posted by venky2600 View Post
but, if you get anything/anywhere about the explanation..plz post it here....thanq


GOLJAN AUDIO LECTURES:

later complication of of MI-ventricular aneurysm: in pt.with 3weeks out of MI-chest bulges-systolic bulges of pericardium is ventricular aneurysm. blood is collecting in aneurysm and making chest bulge out.
aneurysm is lined by scar tissue and therefore will not ruptue. MCC death in a vent:aneurysm=heart failure not rupture. scar tissue which leads to decreased ejection fraction therefore die of heart failure not rupture.
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Old 10-06-2012
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my ans is LAD
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Anatomy-, Cardiovascular-, Pathology-, Step-1-Questions

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