On physical examination, which finding is commonly observed with congenital heart defects?

• A. Clear lungs with no murmur
• B. Normal exam with no signs
• C. Tachypnea and cyanosis
• D. Alveolar hyperinflation with bibasilar crackles

Answer: (C)

Congenital heart defects often disrupt normal oxygen delivery and raise the work of breathing, so the most common exam findings reflect respiratory distress and hypoxemia. Tachypnea appears as the body works harder to compensate for reduced oxygen content and, in many defects, due to increased pulmonary blood flow or congestion. Cyanosis is seen when desaturated blood enters the systemic circulation, signaling lower oxygen saturation. While some defects may have murmurs or later show signs of heart failure, the combination of rapid breathing and bluish discoloration is a classic presenting pattern in many CHD cases. Patterns like a completely clear chest with no murmur or alveolar hyperinflation with bibasilar crackles point more toward primary lung disease or other processes rather than the typical early CHD picture.