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 Best of Five 2.217

 

   

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BOF: 2.217

A 65-year-old male is admitted with a history of breathlessness and swelling of his ankles. He is know to have ischaemic heart disease and has had a myocardial infarct in the past.  On examination there is peripheral oedema, his pulse rate is 100 beats per minute regular, he has an elevated JVP, displaced apex beat, a third heart sound, reversed splitting of the second heart sound and a soft systolic murmur at the apex.

Reversed splitting of the second heart sound occurs in association with:

a)      Left bundle branch block

b)      First degree heart block

c)      Delta wave in lead V1

d)      Right bundle branch block

e)      QT prolongation

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