hour old M. Cyanotic. RR 88 breaths/minute . Parasternal heave on cardiac physical exam. Single loud S2. Soft systolic ejection murmur at the mid-left sternal border. Echo:pulmonary artery arises posteriorly from the left ventricle. Aorta arises anteriorly from the right ventricle. Which of the following best describes expected findings on a radiograph of the chest in patients with this disorder?

CARDIOLOGY

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Question [CLICK ON ANY CHOICE TO KNOW THE RIGHT ANSWER]

A	Decreased vascular markings with a boot-shaped heart
B	Narrow mediastinum associated with mild cardiomegaly
C	Normal heart size with decreased vascular markings
D	None of the above

Explanation:

Detailed explanation-1: -Note that at low LA pressures, the rate of LV pressure development (dP/dt) is much slower than when crossover occurs at higher LA pressures. Hence, the rate of mitral valve closure is increased in mitral stenosis, the principal cause of a loud S1.

Detailed explanation-2: -Mitral regurgitation is a systolic murmur, best heard at the left 5th midclavicular line with possible radiation to the left axilla. It is commonly associated with infective endocarditis, rheumatic heart disease, congenital anomalies, and inferior wall myocardial infarctions.

Detailed explanation-3: -The diastolic murmur of mitral stenosis is of low pitch, rumbling in character, and best heard at the apex with the patient in the left lateral position. It commences after the opening snap of the mitral valve, and the duration of the murmur correlates with the severity of the stenosis.

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CLINICAL MEDICINE

MEDICINE

CARDIOLOGY