A 4-year-old boy is brought to the physician by his mother for a routine well-child examination. He has a 3-week history of mild shortness of breath with exertion. He has had three minor upper respiratory tract infections during the past year. He has been otherwise healthy. His temperature is 37.5oC (99.5oF), pulse is 91/min, respirations are 24/min, and blood pressure is 97/70 mm Hg left arm and 127/86 mm Hg in the right arm. Pulse oximetry on room air shows an oxygen saturation of 98%. Cardiac examination shows a normal S1 and S2; there are no clicks, rubs, or palpable thrills. A grade 1/6 systolic ejection murmur us hears along the left sternal boarder with radiation to the back; there is no diastolic murmur. Which of the following is most likely the diagnosis? a. aortic stenosis b. asd c. atrioventricular septal defect d. coarctation of aorta e. pda f. pulmonary stenosis g. tetralogy of fallot h. total anomalous pulmonary venous congestion i. transpostions j. tricuspid atresia k. truncus arteriosus l. ventricular septal defect
A 4-year-old boy is brought to the physician by his mother for a routine well-child examination. He has a 3-week history of mild shortness of breath with exertion. He has had three minor upper respiratory tract infections during the past year. He has been otherwise healthy. His temperature is 37.5oC (99.5oF), pulse is 91/min, respirations are 24/min, and blood pressure is 97/70 mm Hg left arm and 127/86 mm Hg in the right arm. Pulse oximetry on room air shows an oxygen saturation of 98%. Cardiac examination shows a normal S1 and S2; there are no clicks, rubs, or palpable thrills. A grade 1/6 systolic ejection murmur us hears along the left sternal boarder with radiation to the back; there is no diastolic murmur. Which of the following is most likely the diagnosis?
a. aortic stenosis
b. asd
c. atrioventricular septal defect
d. coarctation of aorta
e. pda
f. pulmonary stenosis
g. tetralogy of fallot
h. total anomalous pulmonary venous congestion
i. transpostions
j. tricuspid atresia
k. truncus arteriosus
l. ventricular septal defect
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