A 54-year-old patient is evaluated in the Pre-Assessment Clinic before undergoing elective surgery for varicose veins. The patient is in good health, with the only significant medical history being well-controlled hypertension with lisinopril. During the examination, the clinician hears an early opening snap in diastole when listening to the patient’s heart. What is the most probable cause of this finding?
A 68-year-old male patient presents with bilateral ankle oedema. On examination, the jugular venous pressure (JVP) is elevated at 7 cm above the sternal angle and there are large V-waves. On auscultation of the heart, a soft pansystolic murmur is audible at the left sternal edge.
Which one of the following is the most likely diagnosis?
A 68-year-old man comes in with bilateral ankle swelling. During the examination, an elevated jugular venous pressure (JVP) of 7 cm above the sternal angle and large V waves are observed. Upon listening to the heart, a soft pansystolic murmur is heard at the left sternal edge. What is the most probable diagnosis?
In a 25-year-old woman undergoing a routine physical examination for a new job, a mid-systolic ejection murmur is discovered in the left upper sternal border. The cardiac examination reveals a significant right ventricular cardiac impulse and wide and fixed splitting of the second heart sound. An electrocardiogram (ECG) shows a right axis deviation, and a chest X-ray shows enlargement of the right ventricle and atrium. What is the most probable diagnosis?
A 49-year-old woman presents to the Cardiology clinic with a heart murmur. During the physical exam, the patient exhibits a collapsing pulse. Upon auscultation, a 2/5 early diastolic murmur is heard at the lower left sternal edge, which is more pronounced during expiration.
What is the most probable clinical sign that will be observed?
A 54-year-old man, with a family history of ischaemic heart disease, has been diagnosed with angina. His total cholesterol level is 6.5 mmol/l. He has been prescribed a statin and given dietary advice. What dietary modification is most likely to lower his cholesterol level?
A 20-year-old man presents with complaints of palpitations and dizzy spells. Upon performing an echocardiogram, the diagnosis of hypertrophic obstructive cardiomyopathy (HOCM) is made.
What will be visualized on the echocardiogram?
A 68-year-old man presents to the Emergency Department with chest pain that began 2 hours ago. He reports that he first noticed the pain while lying down. The pain is rated at 7/10 in intensity and worsens with deep inspiration but improves when he leans forward. The patient has a medical history of long-standing diabetes mellitus and had a myocardial infarction 6 weeks ago, for which he underwent coronary artery bypass grafting. The surgery was uncomplicated, and he recovered without any issues. He smokes 1.5 packs of cigarettes per day and does not consume alcohol. Upon auscultation of the chest, a friction rub is heard. Serum inflammatory markers are elevated, while serial troponins remain stable. What is the most likely diagnosis?
A 76-year-old man with heart failure and depression is discovered to have a sodium level of 130. He is not experiencing any symptoms, and his heart failure and depression are under control. He has slight pitting pedal oedema. He is currently taking ramipril, bisoprolol, simvastatin and citalopram.
What is the optimal approach to managing this patient?
An 81-year-old man with heart failure and depression presents with a sodium level of 130. He is currently asymptomatic and his heart failure and depression are well managed. He has mild pitting pedal oedema and is taking ramipril, bisoprolol, simvastatin and citalopram. What is the optimal approach to managing this patient?