A young female presents with history of dyspnoea on exeion. On examination, she has wide, fixed split S2 with ejection systolic murmur (IIINI) in left second intercostal space. Her EKG shows left axis detion. The most probable diagnosis is :
Answer is C (Ostium primum atrial septal defect) Wide fixed splitting of S2 with ejection systolic murmur in left 2" intercostal space points towards the diagnosis of atrial septal defect.. Presence of left axis detion indicates an ostium primum 4SD. Clinical picture in ASD : Sounds S1Accentuated (Loud) S2 wide fixed split Q Murmur Shunt murmur : is absent i.e. there is no murmur as a result of shunt Flow murmurs: murmurs present are due to increased flow of blood through respective valves Tricuspid valve: Delayed diastolic Pulmonary valve ECG Ostium Q Left axis primum detion Ostium Q Right axis secundum detion + RVH
Total anomalous pulmonary venous drainage
Tricuspid atresia.
Ostium primum atrial septal defect.
Ventricular septal defect with pulmonary aerial hypeension.