male presents with a history of dyspnoea on exertion and orthopnoea, fatigue
and anorexia. On examination he has peripheral oedema, a rapid low volume
pulse, no paradox, elevated JVP with a rapid y descent, no inspiratory
increase in JVP, a quiet praecordium and characteristic auscultatory features
of his condition. He also has hepatomegaly and ascites.
His chest X-ray
demonstrates a small heart with no pericardial calcification.
ECG shows a
widened QRS complex with diffuse non-specific repolarisation changes.
In this patient
the characteristic auscultatory feature mentioned above is:
Third heart sound
Fourth heart sound