CONGENITAL HEART DISEASE

A 26-year-old woman is being evaluated for dyspnea, which she experiences

when she engages in physical activity. She has been having these symptoms for
the past 4 months. She denies having chest pain, orthopnea, or paroxysmal
nocturnal dyspnea. The patients medical history is significant for her having one
episode of atrial fibrillation 1 month ago. Her physical examination shows fixed
splitting of S2 and a 2/6 systolic murmur in the pulmonic area. An
electrocardiogram shows mild right axis deviation and an rSR pattern in V1. A
chest x-ray reveals an enlarged right atrium and main pulmonary artery. Which
of the following is the most likely diagnosis for this patient?
A. Atrioventricular septal defect (AVSD)
B. Ostium secundum atrial septal defect (ASD)
C. Ventricular septal defect (VSD)
D. Dextrotransposition of the great arteries

A 35-year-old man presents to a hospital with fatigue and fever of 3 weeks

duration. He denies having chest pain, dyspnea, or orthopnea. When giving his
medical history, he reports that he has had a heart murmur since birth. On
physical examination, the patient is found to have a temperature of 101 F
(38.3 C); a 3/6 harsh murmur is heard in the left lower sternal border; and the
presence of small, tender nodules are noted on two fingers. These are the only
abnormal findings on physical examination. Which of the following cardiac
anomalies is most consistent with this patients clinical presentation?
A. Ostium primum ASD
B. Patent ductus arteriosus (PDA)
C. Eisenmenger syndrome
D. VSD

A 23-year-old woman with Down syndrome (trisomy 21) presents to establish

care. In general, she appears comfortable. There is no evidence of cyanosis. Her
cardiac examination reveals a soft systolic murmur with a midsystolic click. The
clinical diagnosis of mitral valve prolapse is made. The patients mother wonders
if there are any other cardiac issues. Which congenital heart anomaly is this
patient most likely to have?
A.Ostium primum defect
B. PDA

C. Tetralogy of Fallot
D. Pulmonary stenosis
E. Transposition of great vessels