25 years old male is seen in the clinic for routine physical examination. He has no complaint & he is asymptomatic with no episode of syncope & has no family history of cardiac disease. Systolic murmur is heard at the right lower sternal border. On valsalva maneuver the murmur decrease in intensity, & it is accentuated with inspiration. What is the probable diagnosis? Why?
A. Aortic regurgitation.
B. Mitral regurgitation.
C. Tricuspid regurgitation.
D. Pulmonary stenosis.
E. HOCM.
F. Flow murmur.

hi dear...

i would choose © tricuspid regurgitation cuz:

valsalva maneuver decresese systemic venous flow..so, reducing flow to the right side of the heart...and reducing the murmur..

inspiration increases the blood flow to the right side (cuz of the -ve intrathoracic pressure) thus increaseing the intesity of murmur...

which means it's a murmur on the right side of the heart (C or D)

and from it's location we can choose C...

wallah howa kalam al dr ahmed man6e8e bs al asymtomatic em9'awjatni

علي عادل، تتذكر قبل امتحان صف رابع مدسن عملي، صعدنا للطابق الثامن دنشوف الكيسات، جان اكو واحد شاب مدخليه علمود عنده دي في تي، وإذا تتذكر هو جان فيترجي ورجله وإيده مدهنات، يمكن عثمان يتذكره
ثاني يوم بالامتحان، طلعلي حسن النجار، وداني على الكيس، اني عبالي رح يسألني على الدي في تي، قال لي افحص قلبه، طبعا اني بذاك الوقت ثور الله بأرض الله، ما عرفتها لان اني يادوب اعرف المرمر مال أيورتك ستينوسز
الشاب طلع عنده ترايكسبد ريجيرجيتايشن، وما مبين عليه أي شي واسيمبتوماتك

عفوا، كنت كاتب مايترال بس كان قصدي ترايكسبد

C

C... from site and relation with inspiration + systolic mur.

waiting for the answer too

i cant add any words after ahmed al kaisy
the true answer as my dear ahmed said..c

I doubt that i can actually find out the changes that occur in Valsalva or during inspiration, its Tricus Regurg but i would send the patient for a Doppler Echo anyways

yeah numan i remember , ialso recall that my answer was systolic murmur , he asked what type of systolic murmur, i told him i am not experienced enough to answer that. w en6ani 16