TABLE OF CONTENTS

Respiratory System ………………………………………………………….……………… (1-15)

Cardiology……………………………………………………………………….………………(16-31)

Hematology……………………….……………………………………………….…………..(32-41)

Rheumatology………………………………………………………………………..…….…(42-51)

Gastroenterology……………………………………………………………….…..……….(52-63)

Neurology…………………………………………………………………………..….……….(64-74)

Toxicology……………………………………………………………………….…….….…….(75-81)

Infectious Diseases……………………………………………………….……..………..(82-107)

Kidney Diseases…………………………………………………………….……………..(108-118)

Endocrine ………………………………………………………………….………...……..(119-142)

Dermatology………………………………………………………………..……….……..(143-147)

Psychiatry…………….………………………………………………….…………,,……..(148-152)

2 Marks Questions…………….………………………………………………….……..(153-161)
Medicine NCERT
Author’s Name: Parth Goyal

Published by: Parth Goyal

Madhoganj, Lashkar, Gwalior – 474001

First Edition, 2025

ISBN: 978-81-976158-8-7
Website: www.parthgoyal.in
©Copyright, 2025, Author

All rights reserved. No part of this book may be reproduced, stored in a

retrieval system or transmitted, in any form by any means, electronic,
mechanical, magnetic, optical, chemical, manual, photocopying, recording or
otherwise, without the prior written consent of its writer.

Price: Rs. 1499/-

Printed in India

Author Notes –

These notes are concise notes needed to MBBS students for their
university exams. These are exams ready notes which contains answers
to all IMPS asked in university exams. These notes will save your time
and energy as you can write same as it is pointers to score distinction in
university exams.

Features –

1. Pointwise notes
2. Mnemonics Added
3. University IMP list included
4. Revise Medicine in 48hrs
 IMP-LIST PAPER-1

Medicine IMP LIST - PAPER 1

Endocrinology
Describe types of diabetic neuropathy - MPMSU 21 July - 20 marks

Infectious Diseases
Discuss covid 19 Pneumonia and treatment. - MPMSU 21 July - 20 marks

Respiratory System
Discuss COPD, Diagnosis & it’s management. - MPMSU 19 June, 21 Nov - 20 marks

Discuss aetiology, clinical assessment and treatment of unilateral pleural effusion. - MPMSU
20 Feb - 20 marks

Describe Pathology, diagnosis & Management and Pleural Effusion. - MPMSU 21 Nov - 20
marks

Diagnosis and treatment of acute bronchial asthma. - MPMSU 20 Aug - 20 marks

What is bronchial asthma? describe the treatment of status asthmaticus. - MPMSU 21 April,
24 Feb - 20 marks

Discuss the aetiology, clinical features and treatment of community acquired pneumonia -
MPMSU 22 May - 20 marks

Clinical features of Bronchiectasis. - MPMSU 19 Feb - 5 marks

Pneumoconiosis - MPMSU 19 Jun - 5 marks

Pulmonary function test - MPMSU 20 Feb - 5 marks

Cardiology
Discuss aetiology, pathophysiology, clinical features and management of heart failure. -
MPMSU 20 Feb - 20 marks

Management of Heart failure . - MPMSU 21 July - 5 marks

Describe Etiopathogenesis, Clinical features and Complications of rheumatic Heart Disease. -

MPMSU 20 Aug, 21 April. 24 Feb - 20 marks

MEDICINE DR. PARTH GOYAL

IMP LIST PAPER-2

Medicine IMP LIST - PAPER 2

Nutritional & Environmental Medicine
Discuss balanced diet - MPMSU 19 Feb, 23 Feb - 5 Marks

Pellagra - MPMSU 20 Aug - 5 Marks

Endocrinology
Describe the clinical features and management of Hypothyroidism. - MPMSU 21 July, 19 Jun
- 20 Marks

Discuss Pathophysiology, clinical features, diagnosis and treatment of grave’s disease -

MPMSU 20 Aug - 20 Marks

Describe etiology, clinical features, investigation (2) Management of Hyperthyroidism. -

MPMSU 22 May - 20 Marks

Management of Thyrotoxicosis crisis - MPMSU 24 Feb - 5 marks

Write about Thyroid disorders - MPMSU 20 Feb - 5 Marks

Clinical manifestation of hypopituitarism - MPMSU 21 Nov - 5 Marks

Addison’s disease - MPMSU 20 Aug - 5 Marks

Describe causes, clinical features, diagnosis and management of cushing syndrome. -

MPMSU 21 April, 21 July, 19 Feb - 20 Marks

Classification of Diabetes mellitus. Write about Diagnostic criteria, Clinical features,

management of diabetes mellitus - MPMSU 20 Feb, 21 April - 20 Marks

Management of DM with mention of newer OHAs - MPMSU 21 Nov - 20 Marks

Newer Tx modalities of DM - MPMSU 23 Feb - 5 marks

Describe the etiology, clinical features, investigation and management of diabetic

ketoacidosis. - MPMSU 20 Aug. 19 Feb, 19 Jun - 20 Marks

Write in brief clinical features and management of Hypoglycemia - MPMSU 21 July - 20

Marks

Definition/Diagnostic criteria of metabolic syndrome - MPMSU 21 April, 22 May - 5 Marks

Dapagliflozin - MPMSU 21 July, 22 May - 5 Marks

DR. PARTH GOYAL MEDICINE

P A G E |16 CARDIOLOGY

CARDIOLOGY
Q.9 Aetiology, Pathophysiology, C/F and Mx of Heart Failure? (MPMSU
20 Feb, 21 July – 20 marks)
Ans. Heart Failure is a clinical syndrome due to any structural or

functional cardiac disorder that impairs ability of the ventricle to fill or

eject blood effectively.

Etiology: {MC RO PV – MC RO rahi PV (per vaginal) krne mai}

A. Reduced Myocardial Contractility:

Ɣ Myocardial Ischemia

Ɣ Myocardial Infarction

Ɣ Cardiomyopathy

B. Defective Rate or Rhythm:

Ɣ Tachyarrhythmia

Ɣ Bradyarrhythmia

C. Ventricular Inflow Obstruction:

Ɣ Mitral Stenosis

Ɣ Tricuspid Stenosis

D. Pressure Overload:

Ɣ Hypertension

Ɣ Aortic Stenosis

Ɣ Pulmonary Hypertension

Ɣ Pulmonary Stenosis

E. Volume Overload:
Ɣ Mitral regurgitation
Ɣ Aortic regurgitation
Ɣ Ventricular Septal Defect (VSD)
Ɣ Atrial Septal Defect (ASD)
Pathophysiology:

DR. PARTH GOYAL MEDICINE

CARDIOLOGY PAGE | 17

1. In a normal ventricle, Stroke Volume increases with an increase in

end-diastolic volume (Frank-Starling law).
2. However, in failing heart, this does not happen, resulting in the
accumulation of fluid.
3. Left Ventricular Failure (LVF) causes pulmonary congestion and
Right Ventricular Failure (RVF) causes systemic congestion and in
both LVF and RVF, congestive cardiac failure (CCF) happens.

Heart Failure Restoration of perfusion but

also increased blood volume

Decreased Perfusion

Increased load on heart

Activation of
Increase demand of oxygen
compensatory
of myocardium
mechanisms i.e. RAAS

and ADH release

Myocardial damage & heart

Re-absorption of sodium failure

and water retention

C/F:
Symptoms:
1. Exertional Dyspnea
Ɣ Seen in early heart failure, ultimately present at rest.
2. Orthopnea
Ɣ Dyspnea on lying down
Ɣ Due to increase in pulmonary capillary pressure on lying down
3. Paroxysmal Nocturnal Dyspnea (PND):
x Dyspnea after 1-3 hours of sleep

MEDICINE DR. PARTH GOYAL

P A G E |18 CARDIOLOGY

x Due to accumulation of blood in lungs causing pulmonary

edema, depression of respiratory centre & decrease sympathetic
activity during sleep
4. Pulmonary edema:
x fluid in alveolar spaces due to active rise in capillary hydrostatic
pressure
5. Fatigue due to less blood to skeletal muscles
n
6. Confusion
7. Headache
e due to less blood to the CNS

8. Nausea, anorexia, and abdominal pain due to congestion in the portal

venous system
9. Oliguria: Reduced blood flow to the kidneys.
Physical Signs:
1. General Examination:
Ɣ Peripheral extremities are cold and cyanosed.
Ɣ Elevated jugular venous pressure (JVP)
Ɣ Pitting pedal edema present
Ɣ Low BP
Ɣ Fast pulse with low volume
2. Cardiovascular Examination:
Ɣ Cardiomegaly
Ɣ Audible S3
3. Respiratory Examination:
Ɣ Inspection: Tachypnea
Ɣ Persuccsion: Dull note
Ɣ Auscultation: crepitations due to pulmonary edema
4. Abdomen:
Ɣ Liver enlarged and tender
Ɣ Ascites may be seen
Investigations:
1. Chest X-ray:
Ɣ CTR > 0.5 i.e. Cardiomegaly

DR. PARTH GOYAL MEDICINE

CARDIOLOGY PAGE | 19

Ɣ Hilar haziness: Pulmonary edema

2. ECG
3. Echocardiography
Tx:
1. Control of Excessive Fluid:
Ɣ Salt restriction
Ɣ Diuretics - Furosemide, Torsemide, Thiazides
2. Enhancement of Myocardial Contractility:
Ɣ Cardiac Glycosides – Digoxin, Digitalis
Ɣ Inotropic agents - Dopamine, Dobutamine,
Isoprenaline, Nor-adrenaline
Ɣ Phosphodiesterase Inhibitors - Milrinone, Amrinone
3. Prevention of Ventricular Remodeling:
Ɣ Beta-blockers - Bisoprolol, Carvedilol, Metoprolol
Ɣ ACE Inhibitors - Captopril, Enalapril
Ɣ ARBs - Losartan, Valsartan, Telmisartan

Ɣ Aldosterone Antagonists - Spironolactone, Eplerenone

Q.10 Etiopathology, C/F, Complications of RHD (MPMSU 20 Aug, 21

April - 20 marks)
Ans. Rheumatic fever is an autoimmune inflammatory process that
develops as a sequela of Group A beta-hemolytic streptococcal infection.

Infection by streptococci

Antibodies formed against M protein of streptococci

These antibodies attack cardiac myosin fibers due to

shared epitopes of M protein and cardiac myosin

Etiopathology:
Ɣ Rheumatic fever typically occurs 2-3 weeks after the attack of
pharyngitis

MEDICINE DR. PARTH GOYAL

P A G E |20 CARDIOLOGY

Ɣ commonly affecting children aged 5-15 years.

C/F: (F2C SBH)
1. Fever
2. Fatigue
3. Chills
4. Sore throat
5. Body ache
6. Headache
JONES Criteria:
Major Criteria: (Trick – JoNES Cri.)
JO- Joint pain (Migratory Polyarthritis)
N – Nodules (Subcutaneous)
E - Erythema marginatum
S - Sydenham's chorea
C - Carditis
Minor Criteria: (Trick - FACE PR kiss)
1. Fever
2. Arthralgia
3. CRP: elevated
4. ESR: elevated
5. PR interval: Prolonged
Investigation:
1. CRP and ESR elevated
2. Serological Test
Ɣ Anti-Streptolysin O
Ɣ Anti-DNase B
3. ECG:
Ɣ PR interval prolonged
Ɣ Sinus Tachycardia
4. Echocardiogram:
Ɣ Mitral valvulitis
Ɣ Valvular thickening

DR. PARTH GOYAL MEDICINE

CARDIOLOGY PAGE | 21

Tx:
1. Antibiotics: Benzathine penicillin
2. Anti-inflammatory:
Ɣ Aspirin
Ɣ Corticosteroids: Prednisolone
3. To manage associated heart failure:
1. Diuretics
2. ACE Inhibitors
3. Beta-blockers
Complications of RHD: (Trick – Mai CAPTI RanDi, randi = RHD)
1. Mural thrombi: Thrombi that attach to the wall of the heart
2. Congestive Heart Failure
3. Arrhythmias: Particularly atrial fibrillation in Mitral Stenosis
4. Pericarditis
5. Thromboembolism: Mural thrombi dislodge and form
thromboembolism
6. Infective endocarditis: Bacteria adhere to the damaged valve
7. Mitral Stenosis and Mitral Regurgitation (MS & MR), Aortic
Stenosis (AS), Aortic Regurgitation (AR)
Alternative way to remember-
1. Pericarditis
2. Endocarditis (Infective)
3. CHF
4. MR & MS
5. AS & AR
6. Arrhythmia, particularly AF in MS
7. Mural thrombi

Knowledge
g Cloud 3) Unstable angina

Acute Coronary Syndrome includes:

es: MI = Heart attack, in which there is
imbalance in oxygen supply and
1) ST-segment Elevation Myocardial Infarction
demand, mostly due to plague
(STEMI)
rupture & thrombus formation in
2) Non-ST-segment Elevation Myocardial coronary vessel.
Infarction (NSTEMI)

MEDICINE DR. PARTH GOYAL

P A G E |22 CARDIOLOGY

Q.11 C/F, Diagnosis & Tx of Acute MI. (MPMSU 19 Jun, 19 Feb - 20 marks)

Ans. Acute MI includes both NSTEMI & STEMI

Etiology:
Due to rupture or erosion of atherosclerotic plaque
67(0,ȁ
MI with myocardial necrosis and ST elevation
C/F: [Trick - BDS from SAN Francis Co]
1. Chest pain
Ɣ Pain radiates to neck, left shoulder, and left arm.
Ɣ Squeezing or heavy chest pressure.
2. Burning feeling, i.e. epigastric pain
3. Dyspnea
4. Sweating
5. Syncope
6. Anxiety
7. Nausea / Vomiting
8. Fear of impending death
Diagnosis
1. ECG:
Ɣ ST elevation
2. Biochemical Markers:
Ɣ CK-MB
Ɣ Troponin-T
Ɣ Troponin-I
Troponin is more specific than CK-MB.
3. Echocardiography:
Ɣ Hypokinesia or akinesia due to ischemia
4. Angiography:
Ɣ Identify the site of blockage
Tx:
A. Immediate Measures (MONAC)
1. Oxygen: 4L/min

DR. PARTH GOYAL MEDICINE

CARDIOLOGY PAGE | 23

2. Aspirin 300 mg oral

3. Clopidogrel 300 mg oral
4. Nitrates: Sublingual glyceryl trinitrate 0.4 mg - repeat at 5-
minute intervals up to 3 doses. It relieves chest pain & improved
coronary circulation
5. Inj. morphine 2-5 mg IV: improve chest pain and control
anxiety
B. Specific Mx
6. IV metoprolol 5 mg ȁ'HFUHDVHKHDUWUDWHDQGhence reduce
myocardial oxygen demand. Avoid in asthma or COPD.
7. Anticoagulation therapy: Heparin, LMWH - Enoxaparin
8. Statins: Atorvastatin
C. Reperfusion Therapy
1. Percutaneous coronary intervention (PCI)
x Treatment of choice
x If not available, proceed with fibrinolytic therapy
x Angiography, Balloon Angioplasty comes under this.
2. Fibrinolytic therapy
x Reduce infarct size, limit LV dysfunction
x Reduce incidence of complications like septal rupture, cardiogenic
shock, ventricular arrhythmias
x MOA: They lyse the thrombi and cause recanalization
x It includes:
1. Streptokinase
2. Tissue plasminogen activator (TPA): Alteplase, Reteplase,
Tenecteplase
x Complications of Fibrinolytic Therapy:
Ɣ Bleeding
Ɣ Allergic reactions
NSTEMI ȁ
It is unstable angina with myocardial necrosis as evidenced by elevated
cardiac markers (CK-MB & Troponins).

MEDICINE DR. PARTH GOYAL

P A G E |24 CARDIOLOGY

C/F same as STEMI

Inv:
1. ECG: ST-segment depression, T-wave inversion
2. Cardiac enzymes: CK-MB & Troponins elevated
Tx:

n NSTEMI
Same as STEMI except no Fibrinolytic Therapy in

Q.12 Risk factors, C/F, Tx, Complications of Infective Endocarditis (IE).

(MPMSU 19 Feb, 19 Jun, 23 Feb - 5 marks)
Ans. Etiology
1. Staphylococcus aureus
2. Streptococcus viridans
3. Streptococcus bovis
4. HACEK group: Kingella, Eikenella, Haemophilus,
Cardiobacterium, Aggregatibacter, (Trick – King Eklea pad
gaya, khud ka khoon(Haem) kiya, heart(Cardio) attack se mr
gya, sab Aggregate hoke dekh rhe)
C/F:
1. Systemic Manifestations (F2C SBH):
Ɣ Fever
Ɣ Fatigue
Ɣ Chills
Ɣ Arthralgias
Body ache
Ɣ Myalgias
Ɣ Night sweats
Ɣ Weight loss
2. Cardiac Manifestations: (Trick – our life goal – SPeRM2 ȁ
Vagina mai dalna)
Ɣ Suppurative pericarditis
Ɣ Perforation & rupture of aorta, interventricular septum,
valve leaflets
Ɣ Ring abscess
Ɣ Myocardial abscess

DR. PARTH GOYAL MEDICINE

 CARDIOLOGY PAGE | 25

Ɣ Myocardial infarction
Ɣ Valvular dysfunction: Stenosis or regurgitation
Ɣ Heart failure: Due to valvular dysfunction
3. Embolic Manifestations:
Ɣ Vegetation break and form emboli, emboli lodge at various
location, causing manifestation
2. Cutaneous emboli: Janeway lesions
3. Nail: Splinter hemorrhages
4. CNS: Intracranial hemorrhage
p
5. Septic emboli: Septic infarcts, Mycotic aneurysms

1. Septic
p p
pulmonary
y infarcts
2. Infarcts in spleen, kidney, brain Focal dilation of artery
y

6. Arterial emboli due to weakening

g of

7. Conjunctival hemorrhage artery walls by infection

o
on

4. Immunological Phenomenon:
Ɣ Roth's spots: Circular Retinal hemorrhage
Ɣ Osler nodes: Nodules in fingers
Ɣ FSGN (Focal segmental Glomerulonephritis): Due to
deposition of antigen-antibody complex, flea-bitten kidney
appearance
Complications of IE
A. Cardiac Complications: (Trick – SPeRM2 in Vagina)
Ɣ Supportive pericarditis
Ɣ Perforation & rupture
Ɣ Ring abscess
Ɣ Myocardial abscess
Ɣ Myocardial ischemia
Ɣ Valvular dysfunction
Ɣ CCF (Congestive Cardiac Failure)
B. Embolic events (AiiMS Jodhpur SCHi mila):
Ɣ Arterial emboli

MEDICINE DR. PARTH GOYAL

P A G E |26 CARDIOLOGY

Ɣ Mycotic aneurysm
Ɣ Splinter hemorrhage
Ɣ Janeway lesions
Ɣ Septic pulmonary infarcts
Ɣ Conjunctival hemorrhage
Ɣ Intracranial hemorrhage
C. Immunologic Phenomena:
Ɣ Osler nodes
Ɣ Roth's spots
Ɣ FSGN
Duke's Criteria
Major
1. Blood culture positive.
a. Typical organism from 2 cultures ȁ
Ɣ Streptococcus viridans
Ɣ Streptococcus bovis
Ɣ Staphylococcus aureus
Ɣ HACEK group
OR
Culture +ve drawn 12 hrs apart
OR
Single positive blood culture of Coxiella burnetii
OR
IgG antibody > 1:800
2. Evidence of endocardial involvement
Ɣ +ve Echo findings of vegetations
Ɣ New valvular regurgitation
Minor (FIVE PM)
1. Fever
2. Immunologic phenomena
3. Vascular phenomena
4. Echo results consistent with IE but not meeting major criteria

DR. PARTH GOYAL MEDICINE

CARDIOLOGY PAGE | 27

5. Predisposing heart condition

6. Microbiological evidence
Tx:
1. Viridans & Bovis: Benzylpenicillin + Gentamicin
2. Staphylococci:
Ɣ Penicillin sensitive: Benzylpenicillin
Ɣ Penicillin resistant but methicillin sensitive: Flucloxacillin
Ɣ Both penicillin + Methicillin resistant: Vancomycin +
Gentamicin
3. Surgical Tx: If prosthetic valve endocarditis,
Ɣ Removal of infective material & valve replacement

Q.13 Etiology, C/F & Complications of Mitral Stenosis (MS). (MPMSU 22

May - 5 marks)
Ans. Etiology
1. Gout
2. Rheumatic Heart Disease (RHD)
3. Rheumatoid Arthritis
4. Systemic Lupus Erythematosus (SLE)
5. Amyloidosis
C/F
1. Dyspnea: Due to pulmonary congestion
2. Orthopnea
3. Paroxysmal Nocturnal Dyspnea (PND)
4. Recurrent lower respiratory infections
5. Ascites & edema: when Right vertricle (RV) fails
6. Dysphagia: Due to compression of esophagus
7. Hoarseness of voice: due to Recurrent Laryngeal Nerve (RLN)
paralysis
8. Hemoptysis: Due to pulmonary edema
9. Tricuspid regurgitation

MEDICINE DR. PARTH GOYAL

P A G E |28 CARDIOLOGY

General Examination
1. Mitral facies: Cyanotic lips and face
2. Pulse: Low in volume & irregularly irregular and varying volume
in Atrial Fibrillation (AF).
3. Blood Pressure: Reduced
Inspection & Palpation:
1. Diastolic thrill at apex
2. Epigastric pulsation
Auscultation:
1. Loud first heart sound
2. Loud 2nd heart sound
3. Mitral opening snap
4. Murmur of mitral stenosis: Mid-diastolic murmer
Complications
1. Atrial fibrillation: M/C complication.
2. Thrombus formation
3. Systemic embolization
4. Pulmonary hypertension
5. Pulmonary edema
6. Infective Endocarditis (IE)
7. Hemoptysis
8. Hoarseness of voice
9. Right Heart Failure
Mx:
1. If AF is present, treated by:
Ɣ Digoxin
Ɣ Beta-blockers
Ɣ Calcium Channel Blockers (CCB) like Verapamil,
Diltiazem
Ɣ Anticoagulant therapy to prevent thrombus formation
2. Surgical Mx:
Ɣ Balloon mitral valvotomy

DR. PARTH GOYAL MEDICINE

CARDIOLOGY PAGE | 29

Ɣ Closed mitral valvotomy

Ɣ Open mitral valvotomy
Ɣ Mitral valve replacement

Q.14 C/F and Mx of Cardiogenic Shock (MPMSUI 23 Fev - 5 marks)

Ans.
C/F: (PDle Fati C2T3d)
1. Peripheral vasoconstriction
2. Decreased urine output: Oliguria
3. Fast & feeble pulse
4. Confusion
5. Cold skin
6. Tachycardia
7. Tachypnea
8. Thirst
9. Dyspnea due to pulmonary congestion
10. Hypotension
Mx:
1. Hospitalization
2. Assess airway, breathing, circulation (ABC)
3. Provide oxygen
4. Record vitals (BP, Respiratory Rate (RR), Heart Rate (HR),
Oxygen Saturation)

Circulatory Support
A. To increase myocardial contractility:
1. Dopamine
2. Norepinephrine (NA)
3. Dobutamine
4. Milrinone
B. Mechanical Devices
Ɣ Intra-aortic balloon pump (IABP)
Ɣ Provides temporary yet rapid stabilization

MEDICINE DR. PARTH GOYAL

P A G E |30 CARDIOLOGY

Ɣ Placed in the descending thoracic aorta

Ɣ Inflates during diastole & deflates during systole
Ɣ Can cause decline in afterload due to vacuum effect
Tx of Underlying Cause
Ɣ Angioplasty
Ɣ Corrective surgery

Q.15 Etiology, C/F, Complications, Investigations, and Tx of Aortic

Regurgitation.
Ans. Incompetency of the aortic valve, which causes backflow of blood
from the aorta to the left ventricle during diastole.
Etiology:
A. Acute AR:
ɇ Infective endocarditis(IE)
ɇ Rheumatic fever (RF)
B. Chronic AR:
ɇ Infective endocarditis(IE)
ɇ Rheumatic heart disease,
ɇ Rheumatoid arthritis,
ɇ Connective tissue disorders (CTD): Marfan syndrome,
Ankylosing Spondylitis
ɇ Hypertension.

C/F:

1. Acute AR
ɇ Sudden onset, severe shortness of breath.
2. Chronic AR
ɇ Exertional dyspnea
ɇ Angina pectoris
ɇ Congestive heart failure (CHF)
Signs:
1. Pulse: Prominent, Large-volume, or collapsing.
2. Inspection & Palpation

DR. PARTH GOYAL MEDICINE

CARDIOLOGY PAGE | 31

ɇ Diastolic thrill
ɇ Water-hammer pulse
ɇ Apex beat: Displaced inferiorly towards axilla
3. Auscultation:
ɇ first heart sound: Soft
ɇ second heart sound: Soft
ɇ Early diastolic murmur
Investigations:
1. Cardiomegaly on X-ray.
2. ECG: Left ventricular hypertrophy.
Tx:
1. Vasodilator therapy: To decrease afterload
ɇ Sodium nitroprusside
ɇ Hydralazine
ɇ Nifedipine
2. Surgery: Aortic valve replacement:
ɇ Mechanical valve
ɇ Bioprosthetic valve

MEDICINE DR. PARTH GOYAL