A 28 year old man with complains of headache and nose bleeds also has pain in the lower limbs
on exertion. Exam: radio-femoral delay, cold legs with weak pulse and mild systolic murmur with
normal S1S2. What is the most probable diagnosis?
- a. TOF
- b. ASD
- c. VSD
- d. PDA
- e. CoA (coarctation of aorta)
0 voters
Ans. The key is E. CoA (coarctation of aorta). [headache and nosebleeds - >hypertension, pain in lower
limb on exertion -> as reduced blood supply to leg due to coarctation, radio-femoral delay, cold legs
with week pulse, mid-systolic murmur are all features of coarctation of aorta].
A 75 year old lady who had mitral valve replacement 13 yrs ago has developed recurrent
breathlessness. Her husband has noticed prominent pulsation in her neck. She complains of
abdominal pain and ankle swelling. What is the most probable diagnosis?
- a. Aortic regurgitation
- b. Mitral regurgitation
- c. Mitral stenosis
- d. Tricuspid regurgitation
- e. Pulmonary stenosis
0 voters
Ans. The key is D. Tricuspid regurgitation. [Long standing complication of mitral valve replacement is
tricuspid regurgitation. In tricuspid regurgitation there is recurrent breathlessness (mostly exertional),
prominent pulsation in the neck (giant V wave), abdominal pain due to enlarged congested liver, ankle
oedema due to right heart failure].