Examkin

Question

Difficulty: EasyPediatric Cardiovascular Disorders

Match each common pediatric congenital cardiovascular disorder with its classic physical examination finding.

  • Ventricular septal defectHarsh, holosystolic murmur best heard at the left lower sternal border
  • Atrial septal defectWide, fixed splitting of the second heart sound (S2)
  • Patent ductus arteriosusContinuous, "machine-like" murmur best heard at the left infraclavicular area
  • Coarctation of the aortaDecreased or delayed femoral pulses compared to brachial pulses

Answer

Ventricular septal defect matches with harsh, holosystolic murmur; Atrial septal defect matches with wide, fixed split S2; Patent ductus arteriosus matches with continuous 'machine-like' murmur; Coarctation of the aorta matches with decreased or delayed femoral pulses.
Each congenital heart defect has a distinct pathophysiological mechanism that directly produces its classic physical exam finding. VSD causes systolic flow across the septum (holosystolic murmur). ASD causes volume overload of the right heart (fixed split S2). PDA maintains an aorta-to-pulmonary gradient throughout the cardiac cycle (continuous murmur). Coarctation physically obstructs flow to the lower body (diminished femoral pulses).

Step-by-Step Solution

1
Identify the characteristic clinical sign of a Ventricular Septal Defect (VSD).
Matches with harsh, holosystolic murmur at the left lower sternal border.
VSD is the most common congenital heart defect and presents with a holosystolic murmur due to continuous turbulent flow across the ventricular septum during systole.
2
Identify the characteristic clinical sign of an Atrial Septal Defect (ASD).
Matches with wide, fixed splitting of the second heart sound (S2).
ASD causes persistent right heart volume overload, constantly delaying the closure of the pulmonic valve regardless of the respiratory cycle.
3
Identify the characteristic clinical sign of a Patent Ductus Arteriosus (PDA).
Matches with continuous, "machine-like" murmur.
A PDA maintains an aorta-to-pulmonary artery pressure gradient throughout the entire cardiac cycle, yielding a continuous murmur.
4
Identify the characteristic clinical sign of Coarctation of the aorta.
Matches with decreased or delayed femoral pulses.
The anatomical narrowing in the descending aorta impedes distal blood flow, leading to diminished lower extremity pulses and upper extremity hypertension.

Key Concept

Classic physical examination findings of common congenital heart defects
Estimated Time:1m 0s
Rate this question

Topics

Pediatric Cardiovascular Disorders

More questions from this topic