Sir I’ve a few observations about this lecture. Your lectures are great. A lot of people like me are benefited from listening to your lectures. At 17.26 minutes it is written that systolic ejection murmur is diminished with Valsalva But I read some other books like MKSAP 18 board basics page 11, Master the board 3rd edition page 109 that say that in case of HOCM and MPV this murmur will increase with valsalva maneuver/standing and diuretics
Thank you Dr Bolin! Have watched your videos repeatedly. Just a suggestion: a Family Medicine/General Practice set of videos and questions would be amazing!
I have an exam at the of this week .. i have no time to study every thing .. will his revision vedios be enough for me to get a good scor or shall i go and try to study by my own ?
Great series, Dr Bolin! in Question 8, why isn't pericarditis part of the ddx? Diffuse ST elevation and atypical chest pain in a patient with few risk factor for CAD? Thanks, Steven
Yes Maneuvers that decrease the pre-and/or afterload, such as Valsalva and standing position, may exacerbate the murmur. Mattos, Beatriz Piva e, Torres, Marco Antonio Rodrigues, Rebelatto, Taiane Francieli, Loreto, Melina Silva de, & Scolari, Fernando Luís. (2012). The diagnosis of left ventricular outflow tract obstruction in hypertrophic cardiomyopathy. Arquivos Brasileiros de Cardiologia, 99(1), 665-675
I´d like to disagree with you on the question nr2. I think the most likely diagnosis would be B. MI with FH. Especially if his dad was found post mortem with CAD. According to litterature up to a third of sudden cardiac deaths in young athletes under age 35 is because of premature CAD. Of course the FH added to the alternative B makes it uncertain. But otherwise with a family history of CAD but not of Hypertrophic Cardiomyopathy it makes the CAD more likely.
Respecter Sir, have you written any book on internal medicine similar to your video lectures? Please let me know sir. That will help me more while learning from you. Thanks Sir.
