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  #1  
Old 03-16-2012
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Heart Diagnose this congenital heart disease!

A 2-year-old child with minimal cyanosis has an S3 and S4 (a quadruple rhythm), a systolic murmur in the pulmonic area, and a middiastolic murmur along the lower left sternal border. An ECG shows right atrial hypertrophy and a ventricular block pattern in the right chest leads. Which of the following is the most likely diagnosis?
a. Tricuspid regurgitation and pulmonic stenosis
b. Pulmonic stenosis and a VSD (tetralogy of Fallot)
c. Atrioventricular canal
d. Ebstein anomaly
e. Wolff-Parkinson-White syndrome

Can u explain the findings and how they are consistent with ur diagnosis?

thanks..
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Old 03-16-2012
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I think its A. TR and PS...due to diastolic murmur.....

other options dont fit as vsd should have holosystolic murmur at lower sternal border...ebstein anomaly should have severe cyanosis ....wolff parkinson will have delta wave on ecg....so A....
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Old 03-17-2012
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yes it may be A, bcoz therz atrial hypertrophy and diastolic murmer, other option are not fit
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Old 03-17-2012
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i think the ans is Ebstein anomaly .That is D. there is usually aterialization of the right atrium with small ventricle.
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  #5  
Old 03-17-2012
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Quote:
Originally Posted by tyagee View Post
A 2-year-old child with minimal cyanosis has an S3 and S4 (a quadruple rhythm), a systolic murmur in the pulmonic area, and a middiastolic murmur along the lower left sternal border. An ECG shows right atrial hypertrophy and a ventricular block pattern in the right chest leads. Which of the following is the most likely diagnosis?
a. Tricuspid regurgitation and pulmonic stenosis
b. Pulmonic stenosis and a VSD (tetralogy of Fallot)
c. Atrioventricular canal
d. Ebstein anomaly
e. Wolff-Parkinson-White syndrome

Can u explain the findings and how they are consistent with ur diagnosis?

thanks..
ans is ebstein anomaly. give away is right atrial hypertrophy with block pattern+ cyanosis.
but i cant understand the murmurs....ebsteins has TR...TR should have holosystolic murmuranyone?
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Old 03-18-2012
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Quote:
Originally Posted by tyagee View Post
ans is ebstein anomaly. give away is right atrial hypertrophy with block pattern+ cyanosis.
but i cant understand the murmurs....ebsteins has TR...TR should have holosystolic murmuranyone?
What is the source for mcq?
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  #7  
Old 03-18-2012
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Quote:
Originally Posted by achistikbenny View Post
i think the ans is Ebstein anomaly .That is D. there is usually aterialization of the right atrium with small ventricle.
Then what about the auscultatory finding??
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