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Discussion Starter · #1 ·
A 46-year-old patient is referred to the cardiology department after a primary care physician hears a murmur on cardiac auscultation. Physical examination reveals bounding femoral pulses and carotid pulsations that are accompanied by head-bobbing. This patient most likely suffers from:


A. Mitral stenosis
B. Aortic stenosis
C. Tricuspid regurgitation
D. Mitral regurgitation
E. Aortic regurgitation
F. Pulmonary stenosis
 

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Discussion Starter · #4 ·
E) Aortic regurgitation

Very good guyz. The ans is E) Aortic regurgitation

This patient's physical exam findings are classic for aortic regurgitation (AR). In patients with AR, there is a large left ventricular stroke volume (LVSV) a large regurgitant SV, and a large pulse pressure. The left ventricular end diastolic volume is also increased due to the incompetent aortic valve. Bounding femoral and carotid pulses marked by abrupt distention and quick collapse ("water-hammer" pulses - Mondoshawan mentioned above) are the result of the large pulse pressure. Some patients exhibit head-bobbing with carotid pulsations (de Musset sign - Mondoshawan mentioned above) due to transfer of momentum from the large left ventricular stroke volume (LVSV) to the head and neck.
 
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