Unknown 149

1
Unknown 149
2

• A 45 year old woman is seen for a routine
  examination, and has no complaints.
• Her only past medical history is multiple ear and
  throat infections as a child, which were treated
  with penicillin
• She is on no medications, is married with two
  kids, and doesnt smoke, drink or use drugs.

3

• VS 36.8, 125/40 mmHg, 80, 16, 99 on room air.
• A diastolic murmur is heard at the left lower
  sternal border. Carotid pulse has a rapid
  upstroke.

4

• What is the most likely cause of her abnormal
  cardiac examination?
• Infective endocarditis
• Marfans Disease
• Bicuspid Aortic Valve
• Hypertension
• Rheumatic Heart Disease

5

• What is the most likely cause of her abnormal
  cardiac examination?
• Infective endocarditis
• Marfans Disease
• Bicuspid Aortic Valve
• Hypertension
• Rheumatic Heart Disease

6
C) Bicuspid Aortic Valve in isolated Aortic
Regurgitation

• Aortic regurgitation may be due to disease of the
  valve leaflets or to enlargement of the aortic
  root.
• In the developing world, the most common cause of
  AR is rheumatic heart disease. However, in
  developed countries, AR is most often due to
  aortic root dilation or a congenital bicuspid
  aortic valve

7

• Among patients with a valvular disease, the two
  most common causes were congenital malformation
  (mostly bicuspid aortic valve) in 60-70 percent
  and infective endocarditis in 20-30 percent.

OBJECTIVE diagnose the cause of isolated aortic
insufficiency in a 40-year old patient