MEDizzy - A noncyanotic 2-day-old child has a systolic murmur along

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Pediatric Surgery II

A noncyanotic 2-day-old child has a systolic murmur along the left sternal border; examination is otherwise normal. Chest x-ray and electrocardiogram are normal. Select the most likely congenital cardiac anomaly.

ExplanationB. VSD accounts for 20% to 30% of all congenital cardiac anomalies. It may lead to cardiac failure and pulmonary hypertension if the defect is larger than 1 cm, or it may be asymptomatic if the defect is small. Surgery is not indicated for the asymptomatic patient with a small defect since a substantial number of these anomalies close spontaneously during the first few years of life. Operation is indicated in infants with congestive heart failure or rising pulmonary vascular resistance (owing to the left-to-right shunt). Additionally, operation is indicated if the VSD has not closed by age of 5.