A 9-year-old girl presents with progressive exercise intolerance and dyspnea on exertion. Vital signs show HR 98 bpm, BP 110/68 mmHg, RR 18, SpO2 98% on room air. Cardiac examination reveals a midsystolic ejection murmur at the left upper sternal border with fixed split S2. Echocardiography demonstrates a 12-mm ostium secundum defect in the fossa ovalis region with left-to-right shunting. Chest X-ray shows normal heart size without pulmonary edema. Which of the following is the most likely diagnosis?
- A)Patent foramen ovale
- B)Coarctation of the aorta
- C)Pulmonic valve stenosis
- D)Atrial septal defect of the secundum typeGABARITO
- E)Ventricular septal defect
Explicação
A secundum atrial septal defect occurs at the fossa ovalis and causes a left to right shunt. The hallmark physical finding is a fixed split S2 due to increased right sided flow delaying pulmonic valve closure. The systolic murmur reflects increased flow across... Ver explicação completa e trilha adaptativa →