Standing in Pediatrics — 6yo Child | Pediatric Cardiology | SMLE Q#2816

SMLE Question #2816

Pediatrics Pediatric Cardiology

Objective: OBJ-283

Last updated: February 2026
A 6-year-old boy is brought for a routine check-up. He has normal growth and no exercise intolerance, chest pain, syncope, or cyanosis. Cardiac exam reveals a grade III midsystolic ejection murmur best heard at the left lower sternal border. The murmur is vibratory/musical, has no radiation, and there is no thrill. The second heart sound is normal. The murmur is louder when supine and softer with standing. Which of the following is the most likely cause of this murmur?

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