A nurse is caring for a child diagnosed with Ventricular septal defect (VSD).
The child presents with poor feeding, fast breathing, and sweating with exertion.
Which of the following is the characteristic heart murmur associated with VSD?
A continuous "machinery" murmur that is loudest below the left clavicle.
A harsh holosystolic murmur that is best heard at the left lower sternal border.
A systolic ejection murmur that is best heard at the left upper sternal border.
A systolic ejection murmur that radiates to the back.
The Correct Answer is B
Choice A rationale:
A continuous "machinery" murmur that is loudest below the left clavicle is typically associated with a patent ductus arteriosus (PDA), not VSD.
PDA is a different congenital heart defect.
Choice B rationale:
A harsh holosystolic murmur that is best heard at the left lower sternal border is the characteristic murmur associated with Ventricular Septal Defect (VSD).
This murmur is caused by the blood flowing from the high-pressure left ventricle to the low-pressure right ventricle through the VSD hole throughout the cardiac cycle.
Choice C rationale:
A systolic ejection murmur that is best heard at the left upper sternal border is often associated with aortic stenosis, not VSD.
Choice D rationale:
A systolic ejection murmur that radiates to the back is characteristic of aortic regurgitation, which is a different cardiac condition.
The characteristic heart murmur in VSD is the result of blood flowing from the left ventricle to the right ventricle through the VSD hole during systole.
This causes a harsh holosystolic murmur, which is loudest at the left lower sternal border due to the location of the defect in the ventricular septum.
Therefore, choice B is The correct answer.
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Related Questions
Correct Answer is B
Explanation
Choice A rationale:
A continuous "machinery" murmur that is loudest below the left clavicle is typically associated with a patent ductus arteriosus (PDA), not VSD.
PDA is a different congenital heart defect.
Choice B rationale:
A harsh holosystolic murmur that is best heard at the left lower sternal border is the characteristic murmur associated with Ventricular Septal Defect (VSD).
This murmur is caused by the blood flowing from the high-pressure left ventricle to the low-pressure right ventricle through the VSD hole throughout the cardiac cycle.
Choice C rationale:
A systolic ejection murmur that is best heard at the left upper sternal border is often associated with aortic stenosis, not VSD.
Choice D rationale:
A systolic ejection murmur that radiates to the back is characteristic of aortic regurgitation, which is a different cardiac condition.
The characteristic heart murmur in VSD is the result of blood flowing from the left ventricle to the right ventricle through the VSD hole during systole.
This causes a harsh holosystolic murmur, which is loudest at the left lower sternal border due to the location of the defect in the ventricular septum.
Therefore, choice B is The correct answer.
Correct Answer is A
Explanation
Choice A rationale:
The patient's statement, "My baby's skin and lips have turned bluish," is a classic symptom of cyanosis.
Cyanosis is a bluish or purple discoloration of the skin and mucous membranes, which occurs due to a lack of oxygen in the blood.
In this case, it's associated with a ventricular septal defect (VSD), which is a congenital heart defect that allows oxygen-poor blood from the right side of the heart to mix with oxygen-rich blood from the left side.
Choice B rationale:
The statement, "My baby has difficulty feeding and is not gaining weight properly," may be related to the VSD, but it is not a typical symptom of cyanosis.
This symptom can occur due to congestive heart failure in infants with VSD.
Choice C rationale:
"My baby gets tired quickly during physical activity" can also be associated with VSD and congestive heart failure, but it is not a direct symptom of cyanosis.
Choice D rationale:
"I can hear abnormal heart sounds during the check-up" is not a symptom but rather a sign of a ventricular septal defect.
Abnormal heart sounds, like a loud holosystolic murmur, may be heard on auscultation.
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