Question

Mild systolic ejection murmur at the pulmonary area and fixed split S2:

a) Atrial septal defect (ASD)
b) Ventricular septal defect (VSD)
c) Patent ductus arteriosus (PDA)
d) Pulmonary stenosis

Answer 1

A mild systolic ejection murmur at the pulmonary area and fixed split S2 heart sound are indicative of an atrial septal defect (ASD), a congenital heart defect involving an abnormal opening in the interatrial septum.

Step-by-step explanation:

The clinical finding of a mild systolic ejection murmur at the pulmonary area and a fixed split S2 heart sound generally suggest the presence of an atrial septal defect (ASD). This congenital heart defect results from an abnormal opening in the interatrial septum. Atrial septal defect allows blood to flow between the left and right atria, leading to volume overload on the right side of the heart and increased pulmonary blood flow, which can be heard as a systolic ejection murmur. The fixed splitting of S2 heart sound occurs because the defect causes a constant increase in blood flow to the right side of the heart, extending the right ventricular systole and hence the timing of the pulmonary valve closure independent of respiration.