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  7b (Cardiac) - Answer: 68-year-old female presents with history of aortic stenosis and anterolisthesis

HISTORY: 

This 68-year-old female presents with history of aortic stenosis and anterolisthesis left ventricular hypertrophy.


(QUIZ ANSWER) NOT A FINDING IN THIS CASE: 

Moderately severe pulmonary valve regurgitation.


Using the diagnostic web viewer, we have provided images that assist in telling our clinical story. Areas of significance are indicated below.


FINDINGS:

Status post sternotomy. 

No lymphadenopathy in the visualized chest. 

Visualized liver and spleen are unremarkable. 

Normal left ventricular wall motion and contractility. The left ventricular cavity measures 4.5 x 5.8cm at the end of diastole near the base. Intraventricular septum is 1.5cm. Posterior wall is 1.2cm; posterior wall is 1.1cm; and anterior wall is 1.2cm at the end of diastole. Moderate mitral regurgitation. Moderate mitral valve stenosis.

The right ventricle normal in size and contractility. Moderate-severe tricuspid regurgitation.

The sinus of Valsalva is 3cm in transverse dimension. Sinotubular junction is 2.5cm. The ascending aorta is 3cm. Moderate-severe aortic stenosis. Moderate regurgitation. 

The left atrium measures 5.5cm in AP dimension. Right atrium enlarged. 

Pulmonary valve intact. No regurgitation or stenosis. The common pulmonary artery trunk is 2.9cm. 

No substantive pericardial effusion. 

A small to moderate hiatal hernia. 

No focal areas of decreased perfusion. No evidence of delayed hyperenhancement. 

The calculated LVEF is 57.8%.


CONCLUSION: 

1. Concentric hypertrophic cardiomyopathy. 

2. Moderate mitral regurgitation. Moderate stenosis. 

3. Moderately severe tricuspid regurgitation. 

4. Moderately severe aortic stenosis and moderate aortic regurgitation. 

5. Dilatation of the left and right atria.


Discussion

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430577 1572452 9226428 7b (Cardiac) - Answer: 68-year-old female presents with history of aortic stenosis and anterolisthesis /courses/430577/lectures/9226428 true native_comments
430577 1572452 9226428 7b (Cardiac) - Answer: 68-year-old female presents with history of aortic stenosis and anterolisthesis /courses/430577/lectures/9226428 true text

HISTORY: 

This 68-year-old female presents with history of aortic stenosis and anterolisthesis left ventricular hypertrophy.


(QUIZ ANSWER) NOT A FINDING IN THIS CASE: 

Moderately severe pulmonary valve regurgitation.


Using the diagnostic web viewer, we have provided images that assist in telling our clinical story. Areas of significance are indicated below.


FINDINGS:

Status post sternotomy. 

No lymphadenopathy in the visualized chest. 

Visualized liver and spleen are unremarkable. 

Normal left ventricular wall motion and contractility. The left ventricular cavity measures 4.5 x 5.8cm at the end of diastole near the base. Intraventricular septum is 1.5cm. Posterior wall is 1.2cm; posterior wall is 1.1cm; and anterior wall is 1.2cm at the end of diastole. Moderate mitral regurgitation. Moderate mitral valve stenosis.

The right ventricle normal in size and contractility. Moderate-severe tricuspid regurgitation.

The sinus of Valsalva is 3cm in transverse dimension. Sinotubular junction is 2.5cm. The ascending aorta is 3cm. Moderate-severe aortic stenosis. Moderate regurgitation. 

The left atrium measures 5.5cm in AP dimension. Right atrium enlarged. 

Pulmonary valve intact. No regurgitation or stenosis. The common pulmonary artery trunk is 2.9cm. 

No substantive pericardial effusion. 

A small to moderate hiatal hernia. 

No focal areas of decreased perfusion. No evidence of delayed hyperenhancement. 

The calculated LVEF is 57.8%.


CONCLUSION: 

1. Concentric hypertrophic cardiomyopathy. 

2. Moderate mitral regurgitation. Moderate stenosis. 

3. Moderately severe tricuspid regurgitation. 

4. Moderately severe aortic stenosis and moderate aortic regurgitation. 

5. Dilatation of the left and right atria.