3: Congenital heart disease

Question 1

What is congenital heart disease?

Answer 1

Abnormality of the structure of the heart which is present at birth

Question 2

Congenital heart disease can be detected early through ___ tests.

Answer 2

screening

Question 3

What may newborns with congenital heart disease present with?

Answer 3

Cyanosis

Shock

Cardiac failure

Question 4

What tool can be used to screen for congenital heart defects at 18-22 weeks?

Answer 4

Ultrasound

Question 5

How can antenatally diagnosed CHD be managed?

Answer 5

Surgery

Prostaglandin IV if disease is duct-dependent

Question 6

Generally, if a CHD is only detected after a few months, it is not likely to be ___.

Answer 6

serious

Question 7

After birth, the next opportunity to diagnose CHD is the ___ ___ at around 24 hours.

Answer 7

clinical examination

Question 8

At newborn screening, what signs of CHD are doctors looking for?

Answer 8

Cyanosis

Heart murmurs

Abnormal pulses

Question 9

More than __% of CHD is missed at the newborn clinical examination.

Answer 9

50%

Question 10

Murmurs are (normal / abnormal) in newborns.

Answer 10

normal

Question 11

Which kind of defect is common in newborns and rarely leads to surgical intervention?

Answer 11

Ventricular septal defects (VSDs)

Question 12

Ventricular septal defects (VSMs) in newborns are (serious / unserious) and likely to ___ spontaenously.

Answer 12

unserious

close

Question 13

In a CHD context, why do newborns present with cyanosis?

Answer 13

A condition is causing deoxygenated blood to bypass the lungs and enter the systemic circulation

or

A condition where oxygenated and deoxygenated blood is mixing

Question 14

What can be used, rather than seeing cyanosis, to determine that a newborn is having oxygenation issues?

Answer 14

Oxygen saturation probe

Question 15

What are the three major differential diagnoses in a newborn with cyanosis?

Answer 15

Cardiac disease

Respiratory disease

PPHN

Question 16

Give an example of a congenital heart disease, incompatible with life, which causes babies to present with cyanosis?

Answer 16

Transposition of the great arteries

Question 17

What allows newborns with great artery transposition to survive the first few hours of life?

Answer 17

Patent foramen ovale

Question 18

Between 2-7 days, newborns with undetected CHD are likely to ___ when their ___ close.

Answer 18

collapse / die , ducts

Question 19

What are clinical signs of duct closure related CHD?

Answer 19

Poor perfusion (long CRT, poor pulses, increased work of breathing / tachypnoea)

Rapid deterioration to death

Acidosis

Question 20

What can be used to maintain patency of ducts in newborns with CHD?

Answer 20

Prostaglandin E2