doyoudig
Forum Guru
Topics: 144
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16.) A healthy 4-year-old girl is brought for a well-child examination. A grade 2/6
systolic ejection murmur is heard along the upper left sternal border. S2 is widely
split and does not vary with respiration. A soft mid-diastolic murmur is heard along
the lower left sternal border. Examination shows no other abnormalities. Which of
the following is the most likely diagnosis?
A) Aortic stenosis
B) Atrial septal defect
C) Coarctation of the aorta
D) Mitral valve prolapse
E) Patent ductus arteriosus
F) Pulmonary stenosis
G) Tetralogy of Fallot
H) Transposition of the great arteries
I) Ventricular septal defect
J) Normal heart
Guys how do you differentiate the VSD from an ASD in this particular Case?
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| fudoc_20
Forum Newbie
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Posts: 46
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the answer is atrial septal defect .due to the wide fixed splitting sound which is soo chracterstic to ASD !and rgarding ..the midiastolic murmurs ,some cases of ASD are associated with overflow murmur across mitral valve .
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| fudoc_20
Forum Newbie
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Posts: 46
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ahh and to differntiate between asd and vsd .
in VSD there is apansystolic murmur .over the parasternal are (3rd 4th 5th )left intercostal space .
and more over .the grade of murmur is 2\6 so if the case was VSD .the patient would be presenting with symptoms as the defect would be big !.(rember the intenisty of murmurs is inversly prop to the size of the defect )but here th e pt is asymptomatic
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| khorshid
Forum Guru
Topics: 32
Posts: 591
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ASD, fudoc-20 is right.
VSD systolic murmur + you'd see some symptoms
ASD healthy looking + widely split S2 + soft diastolic murmur.
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| doyoudig
Forum Guru
Topics: 144
Posts: 613
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thx Guys
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