Hannah, a newborn baby, needs surgery because she was born with an aorta that arises from the right ventricle and a pulmonary trunk that issues from the left ventricle, a condition called transposition of the great vessels. What are the physiological consequences of this defect?

You have been called upon to demonstrate the technique for listening to valve sounds.

Explain where you would position your stethoscope to auscultate.

(1) the aortic valve of a patient with severe aortic valve insufficiency and

(2) a stenotic mitral valve.

During which period(s) would you hear these abnormal valve sounds most clearly? (During atrial diastole, ventricular systole, ventricular diastole, or atrial systole?)

What cues would you use to differentiate between an insufficient and a stenotic valve?

Florita Santos, a middle-aged woman, is admitted to the coronary care unit with a diagnosis of left ventricular failure resulting from a myocardial infarction. Her history indicates that she awoke in the middle of the night with severe chest pain. Her skin is pale and cold, and moist sounds are heard over the lower regions of both lungs. Explain how failure of the left ventricle can cause these signs and symptoms.