Pulmonary stenosis: The Daily PANCE Blueprint

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Pulmonary stenosis: The Daily PANCE Blueprint

On physical examination you appreciate a mid-systolic murmur is heard best at the left upper sternal border near the second intercostal space. There is also a variable split of the second heart sound (S2). Which of the following is the most likely diagnosis?

A. Aortic stenosis
B. Pulmonary stenosis
C. Mitral valve prolapse
D. Ventricular septal defect
E. Tricuspid regurgitation

Answer and topic summary

The answer is B. Pulmonary stenosis

Pulmonary stenosis is a relatively rare valvular disorder and is almost always due to a congenital defect, such as Tetralogy of Fallot. The murmur classically is a mid-systolic murmur heard best at the left upper sternal border near the second ICS, and sometimes will have a variable S2 split. An echocardiogram is the best diagnostic test. Balloon valvuloplasty or surgery is indicated in severe or symptomatic cases.

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Smarty PANCE Content Blueprint Review:

Covered under ⇒ PANCE Blueprint Cardiology ⇒ Valvular Disorders ⇒ Pulmonary stenosis

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