Cardiology MCQ 48

Q. A 62-year-old man is seen in the cardiology OPD. During cardiac examination, it is noted that the pulmonary component of the second heart sound occurs before the aortic component. Which one of the following is associated with this finding?

A) Pulmonary stenosis

B) Left bundle branch block

C) Right bundle branch block

D) Atrial septal defect

Answer: B- Left bundle branch block

Explanation:

This patient has reversed splitting of the second heart sound.
Left bundle branch block causes a reversed split second heart sound as it results in a delay in the aortic component.

Other common causes of the reversed splitting of second heart sound are:

Aortic stenosis

RV pacing

WPW syndrome (Type B)

Comments

ECG Spotter

What is the diagnosis? Click the button below to view answer: Show Answer

High heart rate

The patient contacts the doctor over phone with this report. Obviously anxious because of his high heart rate (199 beats per minute) as detected by ECG machine. Should he be worried about this and come to emergency department as soon as possible? Correct answer- ECG machine has calculated his heart rate incorrectly. Heart rate is around 100 beats per minute. Other findings in this ECG include ST segment elevation in anterior chest leads along with presence of Q waves, denoting old MI changes with possibly development of LV aneurysm. In such cases, ST segment elevation can persist for long periods. Now, should he come to emergency department? Not because of detection of high heart rate. But, if he is having symptoms such as shortness of breath or chest pain, he should visit emergency department. Otherwise, if he is asymptomatic, he can schedule a regular visit with his cardiologist.

Learning Cardiology

Search This Blog