Match each classic physical examination finding or auscultatory feature with the most likely associated pediatric congenital heart defect.
- Continuous 'machine-like' murmur heard best at the left infraclavicular areaPatent ductus arteriosus (PDA)
- Fixed, widely split S2 with a systolic ejection murmur at the left upper sternal borderAtrial septal defect (ASD)
- Harsh holosystolic murmur heard best at the left lower sternal borderVentricular septal defect (VSD)
- Upper extremity hypertension with weak, delayed, or absent femoral pulsesCoarctation of the aorta
Answer
The correct matches are: Continuous machine-like murmur with Patent ductus arteriosus; Fixed, widely split S2 with Atrial septal defect; Harsh holosystolic murmur with Ventricular septal defect; and Upper extremity hypertension with delayed femoral pulses with Coarctation of the aorta.
Each listed congenital heart defect produces distinct, classic hemodynamic changes that manifest as pathognomonic physical exam findings. PDA creates continuous aorta-to-pulmonary flow. ASD creates right heart volume overload leading to a fixed split S2. VSD causes high-velocity systolic flow between ventricles. Coarctation physically restricts distal aortic flow, leading to a pressure differential between the upper and lower extremities.
Step-by-Step Solution
Key Concept
Classic clinical presentations of major acyanotic congenital heart defects
Estimated Time:45s