Question

Harsh blowing holosystolic murmur at the fourth left intercostal space:

a) Atrial septal defect (ASD)
b) Ventricular septal defect (VSD)
c) Patent ductus arteriosus (PDA)
d) Pulmonary stenosis

Answer 1

A harsh blowing holosystolic murmur at the fourth left intercostal space suggests a Ventricular septal defect (VSD), characterized by an opening in the interventricular septum.

Step-by-step explanation:

The harsh blowing holosystolic murmur at the fourth left intercostal space is most suggestive of a Ventricular septal defect (VSD). This defect is characterized by an abnormal opening in the interventricular septum, allowing blood to flow between the left and right ventricles during systole, which creates the distinct murmur heard upon auscultation. Common congenital heart defects like VSD, Tetralogy of Fallot, Patent ductus arteriosus (PDA), and Atrial septal defect (ASD) are first detected through auscultation and often confirmed with medical imaging. In particular, the loud murmur associated with VSD can be differentiated from the continuous machinery-like murmur of PDA, the systolic ejection murmur of pulmonary stenosis, and the softer murmur of an ASD.