返信先: 108F-19

TOP 第108回 国試速報掲示板 F問題 108F-19 返信先: 108F-19

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cubie # Posted on 2014年2月11日 at 23:21 修正  削除

何の問題もなくd。PSは頸部に放散する。ASよりは弱いが。
“The murmur of pulmonic stenosis is very similar to that of aortic stenosis. It is a midsystolic high-pitched crescendo-decrescendo murmur heard best at the pulmonic listening post and radiating slightly toward the neck, however the murmur of pulmonic stenosis does not radiate as widely as that of aortic stenosis.”
http://www.learntheheart.com/cardiology-review/systolic-murmurs/
accessed 2/11/2014

“In elderly persons with calcific aortic stenosis, however, the murmur may be more prominent at the apex, because of radiation of its high-frequency components (Gallavardin phenomenon). This may lead to its misinterpretation as a murmur of mitral regurgitation. ”
Aortic Stenosis, emedicine

ASの頸部放散は確かに頸動脈に沿うらしいが、ASで心尖部に放散することもあり(Gallavardin phenomenon)、必ずしも放散=血管の方向と考える必要はないかと。