Cardiovascular Clinic: Extended Matching Questions Formative Self Assessment

A 74-year-old man presents with a painful right lower limb. There is no radio-radial delay, or radio-femoral delay but there is a reduction in volume on the right side when comparing both femoral vessels. There is a femoral bruit present bilaterally. There is an absence of hair on the right limb when compared to the left and his right limb feels colder than the left.

A 23-year-old man presents with lethargy. You note that he has Osler’s nodes present and he has a murmur heard loudest at the 2nd right-intercostal space and also at the mid-left sternal border. The murmur is continuous. He has tattoos on both arms and his chest.

A 52-year-old man has reduced exercise tolerance. On examination you discover that he has a tapping character to his apex beat which is located in the 5th intercostal space in his mid clavicular line. He also has a mid-diastolic murmur which is associated with an opening snap. This murmur is heard loudest at the 5th intercostal space in the mid clavicular line.

A 15-year-old male found to be hypertensive 160/93 mmHg in the right arm and 140/71 mmHg in the left arm was also found to have radio-radial delay as well absent femoral pluses. Other symptoms reported include having frequent headaches and poor performance in sports.

A 63-year-old lady presents with a pulsatile swelling on the left side of neck. She also has signs of left-sided Horner’s syndrome.

A week after experiencing a myocardial infarction a 57-year-old man presents with a pan-systolic murmur. This murmur is heard loudest in the 5th intercostal space in the midclavicular line; it radiates to the axilla. He has crackles present in the lower lobes in his lungs.

A 25-year-old very physically fit man presents with a sensation of dizziness on exertion. You appreciate a heave on the left of his chest. There is a systolic murmur present at the second intercostal space on the right of his chest.

A 71-year-old man presents with erectile dysfunction, requesting Viagra. On examination you note that he has a carotid, renal, aortic and femoral bruit. His abdominal aorta is easily palpable and this has an expansile sensation.

A 72-year-old man has a diastolic murmur which is audible most clearly at the left sternal border. The patient is also found to have a collapsing pulse.