Cardiology: ventricular septal rupture: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Cardiology: ventricular septal rupture

Sample item

A patient on day 3 after anterior MI develops hypotension and a new harsh pansystolic murmur at the left sternal edge with a thrill. Which finding is expected on right heart catheterisation?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Step-up in oxygen saturation from right atrium to right ventricle

A post-MI ventricular septal rupture shunts blood left to right at ventricular level. Right ventricular blood therefore has a higher oxygen saturation than right atrial blood. Echo with colour Doppler confirms the defect.

Option by option

  • A. Equalisation of diastolic pressures

    Equalised diastolic pressures indicate tamponade.

  • B. Fall in oxygen saturation in the pulmonary artery

    Saturation rises, not falls, in the pulmonary artery with a left-to-right shunt.

  • C. Step-up in oxygen saturation from right atrium to right ventricle (correct)

    Correct. Left-to-right shunting at ventricular level causes an oxygen step-up in the RV.

  • D. Elevated v waves in the pulmonary capillary wedge tracing only

    Large v waves are typical of acute mitral regurgitation, not VSR.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is C, Step-up in oxygen saturation from right atrium to right ventricle. A post-MI ventricular septal rupture shunts blood left to right at ventricular level.

Why is "Equalisation of diastolic pressures" not the answer?

Equalised diastolic pressures indicate tamponade.

Why is "Fall in oxygen saturation in the pulmonary artery" not the answer?

Saturation rises, not falls, in the pulmonary artery with a left-to-right shunt.

Why is "Elevated v waves in the pulmonary capillary wedge tracing only" not the answer?

Large v waves are typical of acute mitral regurgitation, not VSR.

What concept does this question test?

It tests Cardiology: ventricular septal rupture in General Medicine. Right ventricular blood therefore has a higher oxygen saturation than right atrial blood. Echo with colour Doppler confirms the defect.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Cardiology: ventricular septal rupture?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.