A 7-year-old girl presents for evaluation of an incidental systolic murmur discovered on routine physical examination. She reports normal exercise tolerance and denies dyspnea or chest pain. Vital signs: BP 110/68 mmHg, HR 92 bpm, RR 18/min, SpO2 98% on room air. Physical examination reveals a systolic ejection murmur at the left upper sternal border with fixed split S2. Chest X-ray shows normal cardiac silhouette. She takes no medications. There is no cyanosis or digital clubbing noted. Which diagnosis best explains these findings?
- A)Ventricular septal defect
- B)Atrial septal defectGABARITO
- C)Tetralogy of Fallot
- D)Coarctation of the aorta
- E)Patent ductus arteriosus
Explicação
Atrial septal defect is correct. A fixed split S2 is the classic finding because chronic left to right shunting increases right sided flow and delays pulmonic valve closure in a relatively constant manner throughout the respiratory cycle. The murmur reflects i... Ver explicação completa e trilha adaptativa →