Question
22. A heart murmur is noted during the preschool physical examination of a 4-year-old girl. An echocardiogram reveals a defect between the right and left atrium involving the limbus of the foramen ovale. What is the most likely diagnosis?
| A. |
Atrial septal defect (ASD), ostium primum
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| B. |
ASD, ostium secundum
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| C. |
Ventricular septal defect
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| D. |
Tetralogy of Fallot
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Show Answer
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Correct Answer � B
Explanation
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Answer : B ASD, ostium secundum
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Ostium secundum– type ASD accounts for 90% of all ASDs.
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It reflects a true deficiency of the atrial septum and should not be confused with patent foramen ovale.
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Ostium secundum defects commonly occur in the middle portion of the septum and vary in size from a trivial opening to a large defect of the entire fossa ovalis.
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A small ASD is unlikely to be functional, but left-to-right shunting may occur in large defects, causing dilation and hypertrophy of the right atrium and ventricle.
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The ostium primum anomaly occurs adjacent to the AV valves and is usually associated with a cleft anterior mitral leaflet.
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Ventricular septal defect occurs in the interventricular septum.
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