Learn the Heart

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✅The answer is D: Causes the absence of an S4 heart sound!

S4, also known as the "atrial gallop," occurs just before S1 when the atria contract to force blood into the LV.

During AF, contraction of the left atrium is lost and thus an S4 heart sound can’t be present.

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Are you ready for this week's quiz? 🤔
Here we go!👍

Atrial fibrillation has what effect on the S4 heart sound? 🫀

A. Increases intensity
B. Decreases intensity
C. Causes the presence of an S4 heart sound
D. Causes the absence of an S4 heart sound

[Learn the Heart @LearntheHeart]

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...C. Diastolic murmur caused by a left atrial myxoma
D. Diastolic murmur at the cardiac apex in the presence of severe aortic regurgitation caused by the regurgitant jet striking the anterior leaflet of the mitral valve mimicking mitral stenosis

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What is the Austin-Flint murmur?🤔
A. Murmur created by severe aortic stenosis heard at the cardiac apex sounding holosystolic and mimicking mitral regurgitation
B. Systolic ejection murmur from the high flow across the aortic valve in a person with severe aortic insufficiency...

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✅The answer to our quiz is B: Dilated cardiomyopathy!

Functional mitral regurgitation occurs when the left atrium or left ventricle dilates, causing the mitral valve (MV) annulus to also dilate, thus preventing the MV leaflets from properly coapting.

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#QuizOfTheWeek
Which of the following is a functional cause of mitral regurgitation?

A. Mitral valve endocarditis
B. Dilated cardiomyopathy
C. Mitral valve prolapse
D. Rheumatic mitral valve disease

[Learn the Heart @LearntheHeart]

...If blood flow is restored via percutaneous coronary intervention or surgical bypass grafting, the function can return to normal.

Viability testing can help determine if myocardium is hibernating or completely infarcted.

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✅Here's the answer to this week's quiz: D. Choices A and C are correct!

Hibernating myocardium occurs when significantly reduced blood flow effects a segment of the myocardium causing dysfunction on a chronic basis...

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...
B. Hibernating myocardium occurs after an acute ischemic insult and reduced function can persist for days to weeks after revascularization
C. Viability testing can discriminate hibernating myocardium from scar
D. Choices A and C are correct
E. None are correct

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🧠Quiz time!

Which is true about hibernating myocardium?

A. Restoring blood flow to a hibernating myocardial segment will result in return of mechanical contractile activity improving systolic function...

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...As compared to valve replacement, repair carries a lower operative mortality, is associated with improved long-term survival and quality of life, and is linked with fewer episodes of endocarditis.

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...Advances in MV repair have generated a paradigm shift in the surgical management of severe primary MR...

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✅The answer is C: Mitral valve repair!

The scenario is consistent with mitral valve prolapse and increasingly severe mitral valve regurgitation (MR).
Myxomatous degeneration of the mitral valve (MV) leaflets leading to MV prolapse is the most common cause of primary MR...

[Learn the Heart @LearntheHeart]

... What is the best approach to management at this time?

A. ACE inhibition
B. Beta-blockade
C. Mitral valve repair
D. Mitral valve replacement

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...On physical exam the breath sounds are normal, but jugular venous pressure is elevated.

She has a mid-systolic click followed by a III/VI systolic murmur at the apex and an S3 heart sound.

There is 1+ pitting lower extremity edema...

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✏️Quiz of the week!

42-yo woman has increasing dyspnea on exertion and ankle edema:

no chest pain
temperature: 37° C
BP 150/90 mm Hg
HR 100 BPM
respirations 20 breaths per minute
O2 saturation 92% ...

[Learn the Heart @LearntheHeart]

...The CHADS 2 score has been largely replaced with the CHA2DS2-VASc score.

Learn more at: https://t.co/Oh3mymWbxc