Audio Qbank – Q41 – A 6F with a VSD

 

A 6-year-old girl is brought to the GP by her mother who reports that she’s had a “pounding” heartbeat for the past two months. Her history is remarkable for a large ventricular septal defect surgically repaired when she was a neonate. Transthoracic echocardiography shows a left to right movement of blood across a ventricular septal defect that has re-opened. Compared to before the defect re-opened, which of the following sets of parameters best reflects this patient’s new cardiac state?

  ↑ Left ventricular pressure; ↓ Right ventricular pressure; ↑ Left atrial pressure
  ↑ Left ventricular pressure; ↓ Right ventricular pressure; ↓ Left atrial pressure
  ↑ Left ventricular pressure; ↓ Right ventricular pressure; ↔ Left atrial pressure
  ↓ Left ventricular pressure; ↑ Right ventricular pressure; ↑ Left atrial pressure
  ↓ Left ventricular pressure; ↑ Right ventricular pressure; ↓ Left atrial pressure
  ↓ Left ventricular pressure; ↑ Right ventricular pressure; ↔ Left atrial pressure

 

Cut-to-the-chase Answer (0:50):
HY USMLE Answer (2:39):