A patient was admitted on the night shift with a diagnosis of acute myocardial infarction. Upon auscultation, the nurse hears a harsh, holosystolic murmur along the left sternal border
The nurse notifies the physician immediately because the symptoms indicate the patient has developed a. papillary muscle rupture. c. ventricular septal rupture.
b. tricuspid stenosis. d. pericardial friction rub.
C
Ventricular septal rupture is a new opening in the septum between the two ventricles. It creates a harsh, holosystolic murmur that is loudest (by auscultation) along the left sternal border. Papillary muscle rupture is auscultation of a new, high-pitched, holosystolic, blowing murmur at the cardiac apex. Tricuspid stenosis is a quiet murmur that becomes louder with inspiration and is located in the epigastrium area. A pericardial friction rub is a sound that can occur within 2 to 7 days after a myocardial infarction. The friction rub results from pericardial inflammation (pericarditis). Classically, a pericardial friction rub is a grating or scratching sound that is both systolic and diastolic, corresponding to cardiac motion within the pericardial sac.
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