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Medicine General 4b3257f1

LVH is commonly seen with :

A
Pure mitral stenosis
B
ASD with fossa-ovalis
C
Aoic incompetance
D
Carcinoid syndrome
High-Yield Explanation
Answer is C (Aoic incompetance) 195.Aoic regurgitation is associated with LV dilatation, LV hyperophy and LVfitilure AR The total volume ejected by the ventricle (forward stroke + volume of blood that regurgitates back into L.V.) is increased in A.R. Also, here, the entire L.V. stoke volume is ejected into a high pressure zone, the Aoa. This leads to dilatation of LV, followed by deterioration of LV function i.e. LVF; Considerable thickening of LV wall (LV hyperophy) also occurs with chronic AR. - Harrison 14th / 1321 M.S. The left ventricular diastolic pressure is normal in isolated Mitral Stenosis. Mitral stenosis leads to elevated left atrial pressure, elevated pulmonary venous and capillary pressures, with resultant increase in right ventricular after load and ultimately RV failure. - Harrison 14th / 1312 ASD An ASD allows shunting of blood from LA to RA and then to RV. It is Rt side of the hea that is primarily involved. No haemodynamic effects are seen on L.V. Carcinoid syndrome Carcinoid syndrome may cause valvular hea disease by causing endocardial fibrosis. However it is the right side of the hea that is usually involved. e Proximal side e of tricuspid and pulmonary valves are involved, leading to tricuspid insufficiency or pulmonary stenosis and thereby secondary 'Right sided hea failure'. Q-Harrison 14th /586, 15th/597

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