A 72yo man has been advised to have antibiotic prophylaxis for some years now before dental
treatment. He has never experienced chest pain. Three weeks ago, he noticed breathlessness on
exertion and for one week he had orthopnea. His pulse is normal. What is the most probable
diagnosis?
- a. Aortic regurgitation
- b. Ischemic mitral regurgitation
- c. Mitral valve prolapse
- d. Pulmonary stenosis
- e. Mitral valve stenosis
0 voters
Ans. The kay is E. Mitral valve stenosis. [Mitral stenosis is the most common valvular complication of
rheumatic fever].
A 67 year old man presents with palpitations. ECG shows an irregular rhythm and HR=140bpm.
He is otherwise stable, BP=124/80mmHg. What is the most appropriate management?
a. Bisoprolol
b. ACEi
c. Ramipril
d. Digoxin
- a. Bisoprolol
- b. ACEi
- c. Ramipril
- d. Digoxin
0 voters
Ans. The key is A. Bisoprolol. [In acute AF (<48h) if stable rate control by verapamil 40-120mg/8hourly
po or bisoprolol 2.5-5mg/d po. In chronic AF (>48h) rate control with beta-blocker or rate limiting CCB;
OHCM, 9th edition, page-124].