AssessmentsAcyanotic congenital heart defects: Pathology review
USMLE® Step 1 style questions USMLE
A 15-year-old girl is brought to the pediatrician for evaluation of leg pain that is exacerbated by exercise. The patient reports having difficulty keeping up with her classmates while playing soccer at school. She has not started having menses. Her mother had menarche at the age of 12. The patient’s temperature is 37.2°C (99.0°F), pulse is 80/min, respirations are 14/min. Upper extremity blood pressure is 140/81 mmHg, and lower extremity blood pressure is 118/70 mmHg. Physical examination reveals a low posterior hairline, Tanner stage I breasts and webbed neck. Which of the following additional examination findings will most likely be seen in this patient?
Content Reviewers:Antonia Syrnioti, MD
In a pediatric cardiology clinic, 4-year-old Tara is brought in by her parents because she has not been acting herself over the past month. The mother also mentioned that she can’t keep up with the other children when playing and often gets fatigued or short of breath. Vital signs include a temperature of 37.0 degrees Celsius or 98.6 degrees Fahrenheit, a heart rate of 100 beats per minute, a blood pressure of 110 over 70 mmHg, and a respiratory rate of 18 breaths per minute. On examination, her skin is pink, and auscultation of the heart reveals a holosystolic murmur over the left sternal border.
Ok, so Tara has some sort of congenital heart defect. Congenital heart diseases are defects in the embryological development of the heart or its major blood vessels. When the defect causes blood to move from the right to the left side, it’s called a right-to-left shunt. This is because deoxygenated blood from th