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Old 07-07-2011
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Heart Gold standard investigation for single S2 and holosystolic murmur

A case profile shows sever cyanosis, development delay. On auscultation there is single S2 with holosystolic murmur near lower left sternal border. which of these is considered gold standard in this case?
A. Chest x ray
B. Ecg
C. Echocardiogram
D. CT
E. MRI
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Old 07-07-2011
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Answer C. Gold standard makes me think of cardiac catheterization but i don t see it as an answer
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Old 07-07-2011
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I m with c echocardiogram
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Old 07-07-2011
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echocardiogram is the best
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what about diagnosis? what it could be? though question have not asked but still want to know how u diagnose?
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Old 07-07-2011
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gold standard is echo if the case is TOF as i think because holosystolic murmur and cyanosis
C. Echocardiogram
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Old 07-07-2011
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Quote:
Originally Posted by miss patho View Post
gold standard is echo if the case is TOF as i think because holosystolic murmur and cyanosis
C. Echocardiogram
severe cyanosis, single s2, holosystolic murmur ..why not Tricuspid atresia. Since Tricuspid atresia too have holosystolic murmur(vsd), pda,most of them will have pulmonary stenosis(s2 single), so i think cyanosis and age at presentation will differentiate both of these.

Tricuspid atresia present with cyanosis at infancy, nasal flaring, retraction of intercoastal muscles, CHF, poor growth. As well bacterial endocardities and brain abscess commom presentation. so neurological features are present. SEM click of PULMONARY origin

TOF: Cyanosis at birth, chf, poor growth, holosystolic murmur, single s2, clubbing, Squating relief sym, SEM click of AORTIC origin ...I think this are differentiating scenario....plz add any thing want to add..just had confusion on how to differentiate both conditions if they are given simultaneously...nowits clear to me..but i think they wont give that close in exam

Here diagnosis is c. Echocardiogram
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