MCQ Pediatrics Answer 10
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This is a rather classic presentation for a small ventricular septal defect (VSD). The murmur is due to an increasing left-to-right shunt as the pulmonary vascular pressure falls with normal maturation. A larger VSD will usually present with heart failure by this age and the murmur may be less noticeable. The other choices are all examples of right-to-left shunts, and cyanosis, usually from birth would therefore be a prominent feature.
Ref: Behrman RE, Kliegman EM, Arvin AM (eds): Nelson Textbook of Pediatrics, ed 15. WB Saunders Co, 1995, pp 1292-1294.
Tags: MCQ, Pediatrics, VSD, Murmurs
Category: Pediatrics MCQs
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