Download ASD Case for Reno Mrs. Young

Mrs. Young has chest pain
Mrs. Young is a 35 year old woman admitted to the
hospital to determine the cause of her complaint of
vague chest pains in stressful situations.
Studies carried out at another hospital two years ago had
included a chest x-ray which revealed right ventricular
enlargement. A moderate systolic murmur and a split
second heart sound were found at that time.
1. List the possible causes of a systolic murmur.
2. What is a split second heart sound and what can
cause it to appear?
Based on the initial findings, Mrs. Young underwent cardiac
catheterization. The following data was obtained.
MEASUREMENT
Heart rate
Ventilation
O2 consumption
[Hemoglobin]
O2 content – mixed venous
blood
O2 content – pulmonary artery
RESULTS
85/min
5.46 L/min
219 ml/min
13.4 gm/dL
13.14 ml/dL
O2 content – pulmonary vein
17.78 ml/dL
O2 content - aorta
17.78 ml/dL
16.31 ml/dL
3. Examine the data above and decide whether any of it
is abnormal and requires explanation.
4. What pathology must be present in Mrs. Young’s
cardiovascular system to result in the data seen
above?
5. We know that Mrs. Young has a shunt from the left
to the right side of the cardiovascular system. What
are possible locations for this shunt?
6. How would you determine which of the possibilities
is actually present?
The following pressures were recorded during Mrs.
Young’s cardiac catheterization.
MEASUREMENT
Right atrium (mean)
Right ventricle (systolic/diastolic/end
diastolic)
Pulmonary artery
(systolic/diastolic/mean)
Left atrium (mean)
Left ventricle (systolic/diastolic/end
diastolic)
Aorta (systolic/diastolic/mean)
RESULTS (mm Hg)
6
30/2/8
30/6/14
6
106/-3/10
102/66/84
7. Using this data determine the location of
Mrs. Young’s shunt.