A 5-week-old infant is brought by his mother due to weight loss concern. She states that the infant has difficulty breathing and profuse sweating with feeds. The patient was born at 38 weeks gestation via spontaneous vaginal delivery. Weight is at the 5th percentile. On cardiac examination shows a holosystolic murmur at the left lower sternal border; a palpable thrill is present at the left sternal border. Compared to a healthy infant, this patient likely has which of the following intracardiac pressure changes?

Question

A 5-week-old infant is brought by his mother due to weight loss concern. She states that the infant has difficulty breathing and profuse sweating with feeds. The patient was born at 38 weeks gestation via spontaneous vaginal delivery. Weight is at the 5th percentile.  On  cardiac examination shows a holosystolic murmur at the left lower sternal border; a palpable thrill is present at the left sternal border.  Compared to a healthy infant, this patient likely has which of the following intracardiac pressure changes?

Quizplus · Accepted Answer

Eductional Objective: Ventricular septal defect causes left-to-right shunting with increased right ventricular pressure and, if large, left-sided volume overload with increased left ventricular and left atrial pressures.  A holosystolic murmur is characteristic, and failure to thrive and signs of heart failure (eg, poor feeding, diaphoresis) can occur.

A 5-Week-Old Infant Is Brought by His Mother Due to Weight