Cardiology

Question 1

CCHD lesions that are usually cyanotic (7)

Answer 1

Hypoplastic left heart
Pulmonary atresia with intact ventricular septum
Total anomalous pulmonary venous return
ToF
Tricuspid atresia
Transposition of the great arteries
Truncus arteriosus

Question 2

CCHD lesions that may be cyanotic (5)

Answer 2

Coarctation of the aorta
Double outlet right ventricle
Ebstein’s anomaly
Interrupted aortic arch
Defects with single ventricle physiology

Question 3

What is a borderline screening result for pulse ox screening?

Answer 3

Sats 90-94%
> 3% difference between limbs

3 borderline readings 1 hour apart = a fail

Question 4

Which mechanism of SVT is more common in
1. Newborns, infants, young children
2. Older children, adolescents, adults

Answer 4

1. AVRT
2. AVNRT

Question 5

3 CXR findings seen in coarctation in older children

Answer 5

Cardiomegaly
3 or reverse 3 sign (notching of the aortic isthmus in the left superior mediastinum)
Rib notching (erosion of the ribs from large collaterals)

Question 6

What genetic condition is commonly associated with coarctation?

Answer 6

Turner syndrome

Question 7

Which cyanotic heart disease is the only one where pre-ductal sats are higher than post? Why?

Answer 7

Transposition of the great arteries
Blood from the LV is more cyanotic before it reaches the PDA where some mixing can occur

Question 8

Which cyanotic heart lesion gets worse with prostaglandin? Why?

Answer 8

TAPVR
Closing the PDA allows for more blood to flow systemically - with the PDA open mixed blood will continue to flow from the aorta to the pulmonary system and reduce the amount of blood going to the body