Block 2 Case 20 Answers

A 70 year old man presents to the doctor for a routine physical. When you listen to his heart you hear the following:

What kind of murmur does he have? Aortic stenosis

What is the most likely cause of his murmur? calcified deposits due to "wear and tear"

It this a typical finding in a 70 year old man? No, typically the murmur would be heard in a man over 80. The fact that you are hearing the murmur now suggests that he has a bicuspid aortic valve. 

Name 4 symptoms associated with this murmur

1. fatigue
2. dyspnea on exertion
3. angina
4. syncope
5. sudden cardiac death

If he spiked a fever after having dental work what would you be concerned of? Strep viridans subacute endocarditis

If he had an aortic valve replacement what type of infective endocarditis would he be more at risk of contracting? Staph. Epidermidis is found in patients who have had a valve replacement. He could also still get Acute bacterial endocarditis (Staph. Aureus) or Subacute bacterial endocarditis (Strep Viridans).

http://emedicine.medscape.com/article/2018199-overview#aw2aab6c10