Match each of the following pediatric congenital heart defects with its classic clinical or auscultatory finding.
- Ventricular septal defectHarsh, holosystolic murmur at the left lower sternal border
- Atrial septal defectWide, fixed splitting of the second heart sound (S2)
- Patent ductus arteriosusContinuous, machine-like murmur at the left infraclavicular area
- Tetralogy of FallotEpisodes of severe cyanosis that improve with knee-chest positioning
Answer
Ventricular septal defect matches with a harsh holosystolic murmur. Atrial septal defect matches with a wide, fixed split S2. Patent ductus arteriosus matches with a continuous machine-like murmur. Tetralogy of Fallot matches with cyanotic episodes that improve with knee-chest positioning.
Each congenital heart defect alters hemodynamics in a specific way that leads to classic, identifiable clinical signs. VSD produces a holosystolic murmur due to continuous systolic left-to-right shunting. ASD causes delayed pulmonic valve closure due to increased right-sided volume, creating a wide, fixed split S2. PDA produces a continuous machine-like murmur because aortic pressure exceeds pulmonary artery pressure in both systole and diastole. Tetralogy of Fallot features hypercyanotic spells caused by right-to-left shunting, which are relieved by increasing systemic vascular resistance (such as assuming a knee-chest position).
Step-by-Step Solution
Key Concept
Hallmark clinical presentations of common congenital heart defects
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