Continuous murmur can be heard in all except:
(A) VSD with aoic regurgitation (B) Coronary AV fistula (C) Pulmonary AV fistula (D) Patent ductus aeriosus
(A) Ans: A. VSD with aoic regurgitation(Ref Harrison 19/e p51e-2, 1449, 18/e p 1829)VSD with aoic regurgitation:Produces pansystolic & early diastolic murmur, not continuous.Continuous murmur:Classic example - PDA.Usually heard in second or third interspace.At a slight distance from sternal border.Other causes:Causes of Continuous MurmursContinuous murmur caused by blood flowContinuous murmurs caused by high-to-low pressure shuntsContinuous murmurs secondary to localized aerial obstructionVenous humMammary souffleHemangiomaHypehyroidismAcute alcoholichepatitisHyperemia of neoplasmHepatomaRCCPaget's diseaseSystemic aery to pulmonary aeryPatient ductus aeriosusdegAoopulmonary windowTruncus aeriosusdegPulmonary atresiadegAnomalous left coronary aerySequestration of the lungSystemic aery to right heaRuptured sinus of ValsalvadegAV fistula (systemic or pulmonic)degCoronary AV fistulaLeft-to-right atrial shuntingLutembacher syndromeMitral atresia plus atrialseptal defectVenovenous shuntsAnomalous pulmonaryveinsPoosystemic shuntsBronchiectasisCoarctation of aoaBranch pulmonary aerystenosisCarotid aery occlusionCeliac mesentericocclusionRenal aery occlusionFemoral aery occlusionCoronary aeryocclusion