An 11-Year-Old Boy Is Brought to the Office for a Routine

question 342

Multiple Choice

An 11-year-old boy is brought to the office for a routine checkup prior to enrollment at summer camp.  The patient and his mother report no health concerns.  Family history is significant for his father passing away suddenly from a heart condition 2 years ago.  The patient is at the 75th and 80th percentiles for height and weight, respectively.  Vital signs are normal.  Physical examination shows a well-appearing child.  The lungs are clear to auscultation.  Cardiac auscultation findings at the left lower sternal border are given below.  The auscultatory abnormality intensifies with the handgrip exercise.  Which of the following is the most likely diagnosis?

• A)Aortic regurgitation
• B)Aortic stenosis
• C)Atrial septal defect
• D)Hypertrophic cardiomyopathy
• E)Patent ductus arteriosus
• F)Ventricular septal defect

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