Enlarged RV in emphysema – MCQ – Answer

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Enlarged RV in emphysema – MCQ – Answer

Enlarged right ventricle (RV) in pulmonary emphysema is felt as – Correct answer: c) Epigastric pulsation

The classical finding of left parasternal heave will not be appreciated in those with pulmonary emphysema as the lung overlaps the heart in the parasternal region. Right ventricular enlargement in this situation is felt as a prominent epigastric impulse, which can be better appreciated in inspiration. The differential diagnosis of an an epigastric impulse is an aortic pulsation, which is better felt on the ventral aspect of the palpating finger while RV impulse is felt at the tip of the finger.

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Reference: Braunwald’s Heart Disease: A Textbook of Cardiovascular Medicine, 10th Edition. Chapter 8: Physical Examination of the Heart and Circulation