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Real Doctors (Life Makers)  |  Clinical  |  Pediatrics  |  Case discussion  |  case discussion 2 « previous next »
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Author Topic: case discussion 2  (Read 7667 times)
3abeer
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case discussion 2
« on: /September/ 30, 2005, 09:42:29 AM »

a 2yrs old male, previously healthy, was reffered to you by a GP, because of the incidental discovery of a murmur.
by history, no cyanosis, no symptoms of heart failurre or execise intolerance . the child was born ny full term normal vaginal delivery, after uneventfull pregnancy

physical exam:Spo2: 98% in room air, looks well, not in distress, well built,
by auscultation: S1, & S2
EJECTION SYSTOLIC MURMUR, BEST HEARED OVER THE LEFT 2ND INTERCOSTAL SPACE, grade 2, not radiating , no added sounds

1- put 3 differential diagnosis
2- what is your 1st investigation?
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dr donia
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Re: case discussion 2
« Reply #1 on: /October/ 10, 2005, 02:50:57 PM »

salam dr 3abeer  Smiley
i missed u , it has been long time since my last visit to this site .
i think this child has a type of congenital heart disease ,i will search and know more details to tell next tine N shae allah
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3abeer
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Re: case discussion 2
« Reply #2 on: /October/ 16, 2005, 05:34:05 AM »

i missed u too donia
RAMADAN KAREEM

love u 4 the sake of ALLAH
WAITING 4 UR ANSWER  Grin

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dr donia
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Re: case discussion 2
« Reply #3 on: /October/ 16, 2005, 03:15:52 PM »

salam dr 3abeer: ramadan  kareem Smiley
احبك الذى احببتنى فيه
? i think the  DD will be

1- ASD : in which there is ejection syst. murmur + wide fixed split second sound

2- pulmonary stenosis

3- fallot's tetralogy but in this child there is no parasternal pulsationa or thrill or any features of cyanosis

4- hemic murmur : which indicate severe anaemia
5- innocent murmur? heard in normal children ( it is the most probable diagnosis? according to the data u mentioned )
[u] the 1st investigation
1- CBC : to exclude anaemia as as cause of murmur
2- echicardiography : to exclude pathological murmur of CHD
« Last Edit: /October/ 16, 2005, 03:21:18 PM by dr donia » Logged
 
3abeer
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Re: case discussion 2
« Reply #4 on: /November/ 01, 2005, 06:32:18 AM »

salam donia:

good dear
the main 3 D dx
1- ASD
2- PS ( which is the coz of murmur in tetralogy also)
3-partial annomolous pulmonary venous return



the innocent murmur is typically after that age although can be at any age

clapping well done
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