Pediatrics Question #5


Which assessment finding is most closely associated with an atrial septal defect in a 2-month-old infant?


  1. Heart tones that are distant and muffled
    • Rationale:
  2. A murmur heard upon auscultation
    • Rationale:
  3. Sporadic hypercyanotic episodes
    • Rationale:
  4. Strong upper extremity pulses
    • Rationale:



The correct answer is B. A murmur is heard upon auscultation at the pulmonic position during systole and diastole. Aortic insufficiency and some cases of mitral insufficiency cause heart tones that are distant and muffled. Shortness of breath can occur with activity or feeding however hypercyanotic episodes occur with tetralogy of fallot. A child with atrial septal defect can experience an irregular heart rate/irregular pulses.

Learning Outcomes

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