Pediatric Cardiology Clinical Vignettes

Listen to the podcast for why each multiple choice answer is right or wrong!

1. A 9 YO boy presents to your clinic with widened pulse pressure, paradoxical splitting of S2 and a continuous machinery-type murmur that is heard best in the 2nd left intercostal space and widely transmitted over the precordium. No cyanosis present. What is the most likely diagnosis?

A. Ventricular septal defect.
B. Atrial septal defect.
C. Coarctation of Aorta
D. Patent Ductus Arteriosus.

2. A 15-year-old man presents after fainting while playing a basketball game. The patient states he was shooting when he felt lightheaded and subsequently passed out. On presentation, he is asymptomatic and has completely normal vital signs. Using your stethoscope, you hear a crescendo-decrescendo murmur at the left sternal border. What diagnosis should be suspected in this patient?

A. Still's murmur
B. Eisenmenger's syndrome
C. Hypertrophic cardiomyopathy
D. Venous hum

3. It’s your 3rd week at your pediatric rotation and a 8-year-old girl is brought in by his mom for strange behavior. She’s had intermittent fevers at night for the past week and reports L knees, bilateral ankle and R elbows joint pain and swelling. As she’s sitting on your exam table, her hands are writing uncontrollably and she maintains she can’t control them. On exam, a diastolic murmur is noted at the right upper sternal border. Which of the following diagnoses is most consistent with her symptoms?

A. Acute Rheumatic Fever
B. Pulmonic stenosis
C. Aortic stenosis
D. Tetralogy of Fallot


1. D. Patent ductus arteriosus
2. C. Hypertrophic cardiomyopathy
3. A. Acute Rheumatic Fever

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