A 50-year-old man is being evaluated after a myocardial infarction, he states that he has felt recently a difficulty of breathing and fatigue. He sleeps using 2 pillow to help relieve dyspnea during night. He has a significant history of hypertension and diabetes mellitus. On cardiac auscultation, a low-frequency diastolic heart sound is heard shortly after the second heart sound when the patient lies in the left lateral decubitus position. Cardiac imaging shows hypokinesis of the left ventricular free wall. Which of the following is most likely to accentuate this patient's abnormal auscultation finding?

Question

Quizplus · Accepted Answer

Eductional Objective: Due to rapid ventricular filling and sudden deceleration of blood when the ventricle reaches its elastic limit. S3 is heard best with the bell of the stethoscope in the mitral area with the patient in a left lateral position. An early diastolic sound that is heard immediately after S2 Ventricular gallop: S1 is followed by S2 and S3 in close succession, resembling the cadence of the word "Kentucky" (Ken-TUC-ky) on auscultation.

A 50-Year-Old Man Is Being Evaluated After a Myocardial Infarction