A 50-year-old female patient at has been diagnosed with a heart murmur. A murmur of relatively low pitch is heard maximally over the second intercostal space to the right of the sternum. The chest radiograph shows an enlarged heart. The mean QRS axis of the electrocardiogram is -45 degrees. What is the diagnosis?

Question

Quizplus · Accepted Answer

The murmur heard over the second intercostal space to the right of the sternum suggests aortic valve stenosis. The enlarged heart seen on the chest radiograph may be due to the increased workload on the heart resulting from the stenotic valve. The mean QRS axis of -45 degrees is consistent with left ventricular hypertrophy, another possible consequence of aortic valve stenosis. The other options (mitral valve stenosis, pulmonary valve stenosis, tricuspid valve stenosis, tricuspid valve regurgitation) are less likely given the location of the murmur and the electrocardiogram findings.

A 50-Year-Old Female Patient at Has Been Diagnosed with a Heart