Acyanotic congenital heart defects Quiz: Ace Your Exams

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An 18-year-old young man comes to his outpatient provider for evaluation of exertional shortness of breath. It worsens with exercise and improves with rest. Past medical history is notable for asthma, for which he uses an albuterol inhaler occasionally. His temperature is 37.0°C (98.6°F), blood pressure is 115/74 mmHg, and pulse is 67/min. Physical exam is notable for a systolic murmur most prominent at the left upper sternal border, as well as fixed-splitting of the S2 heart sound. Which of the following is the most likely underlying pathophysiology of this patient’s condition?

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Incomplete fusion of the septum primum with septum secundum

Incomplete fusion of the septum primum with endocardial cushions

Impaired growth of the septum secundum

Calcification of the aortic valve

Impaired development of the membranous interventricular septum