The Correct Answer is B!

Knowledge to Practice, in collaboration with Mayo Clinic, offers Online Cardiovascular Medicine Board Review to help you bring the most current medical knowledge back to your daily practice. With access to a personalized and adaptive online learning curriculum you will save study time, and gain confidence to pass the exam. Our products have been shown to increase knowledge 75% more than traditional methods in less time.1

Question:

A 44 year-old man has a systolic murmur and symptoms of exertional dyspnea and light headedness. The cardiac catheterization traces show the left ventricular (LV) and aortic (Ao) pressures after a premature ventricular contraction (PVC).

What is the mechanism of the outflow tract obstruction?

  1. Dynamic left ventricular outflow obstruction of H
  2. Fixed valvular aortic stenosis
  3. Increased gradient due to acute severe aortic regurgitation
  4. Mid-ventricular obstruction of HCM

Answer Rationale:

In patients with left ventricular outflow obstruction, the etiology of the obstruction can be determined by the pulse pressure that occurs on the beat after a PVC. With dynamic LVO or midventricular obstruction, there is a decrease in pulse pressure on the post PVC beat. In severe acute aortic regurgitation, there should be a wide pulse pressure during NSR and after a PVC. In this patient, there is an increase in gradient but also an increase in pulse pressure after a PVC, indicating fixed obstruction.

1.  Source: "Comparative Analysis of Pre/Post Assessments of Live/Didactic Course Attendees when compared to Mico-Learning/Online Course Users., "Knowledge to Practice, 2017.

 This offer ends on January 26th at 11:59 PM EST.