A 70-year-old male patient at UMC has been diagnosed with a heart murmur. A chest radiograph shows an enlarged heart. The mean QRS axis of his electrocardiogram is -40 degrees. Pulmonary wedge pressure is elevated and rales are present. What is the diagnosis?

Question

Quizplus · Accepted Answer

The presence of a heart murmur, an enlarged heart on chest radiograph, elevated pulmonary wedge pressure, and rales are all indicative of heart failure. The mean QRS axis of -40 degrees suggests left ventricular hypertrophy, which is commonly seen in aortic insufficiency. Mitral stenosis would present with a mid-diastolic murmur, while pulmonary valve stenosis and tricuspid stenosis are unlikely causes of heart failure in this age group. Tricuspid regurgitation may be present in some cases of heart failure, but is not as commonly associated with aortic insufficiency.

A 70-Year-Old Male Patient at UMC Has Been Diagnosed with a Heart