Cardiology

Question 1

What makes up the Pentalogy of Fallot?

Answer 1

Large VSD
R ventricular outflow obstruction (pulmonary stenosis)
Overriding aorta
R ventricular hypertrophy
ASD

Question 2

What 2 maternal conditions are most commonly associated with cardiac defects in newborns?

Answer 2

Maternal DM

Maternal PKU

Question 3

What are the 2 major prenatal R->L shunts and what do they bypass?

Answer 3

Liver bypassed by ductus venosus (placenta)

Lungs bypassed by ductus arteriosus and foramen ovale

Question 4

What is the role of the ductus arteriosus?

Answer 4

Bypasses the lungs by shunting blood from pulmonary trunk/artery to L atrium

Question 5

What are ductus dependent heart defects?

Answer 5

Severe L sided obstruction - e.g. Hypoplastic L heart syndrome, severe aortic stenosis, pulmonary atresia, ToGA, interrupted aortic arch
When pressure reverses after birth and ductus arteriosus closes, baby goes into CV collapse

Question 6

How are babies with ductus dependent heart defects prevented from going into CV collapse after birth?

Answer 6

Prostaglandin infusions to keep ductus arteriosus patent

Question 7

What AP CXR finding suggests ToF and what is this caused by?

Answer 7

Boot shaped heart - pulmonary artery

Question 8

What does a cyanotic neonate at 2-3 days suggest in terms of congenital heart disease?

Answer 8

Most commonly ToGA; or severe ToF

Question 9

What is the most common presentation of L->R heart shunts (non-cyanotic heart disease) and what are the 3 most common causes?

Answer 9

Breathlessness
VSD
ASD
PDA

Question 10

What are the 2 most common causes of R->L (cyanotic) heart defects?

Answer 10

ToF

ToGA

Question 11

What are the 2 most common causes of an asymptomatic child with a heart murmur?

Answer 11

Aortic stenosis

Pulmonary stenosis

Question 12

What is the most common mixed heart defect causing a breathless, blue child?

Answer 12

Complete AV septal defect

Question 13

What does maternal SLE typically cause in newborns?

Answer 13

Complete heart block

Question 14

What are the 4 S’s suggestive of an innocent heart murmur in a kid?

Answer 14

Soft, blowing
Symptomless
Systolic murmur loudest at L Sternal edge

Question 15

What are innocent murmurs in kids often due to?

Answer 15

Illness - febrile or anaemia, due to increased CO

Question 16

What defects are most likely to cause neonatal heart failure?

Answer 16

Ductus dependent ones - critical L outflow tract obstruction e.g. ToGA, Hypoplastic L heart syndrome, severe aortic coarctation/aortic arch interruption, critical aortic valve stenosis

Question 17

What is Eisenmenger syndrome?

Answer 17

Chronically raised pulmonary arterial pressure and flow - chronic pulmonary hypertension and eventually R heart failure

Question 18

What does blue teenagers suggest in terms of heart defects?

Answer 18

Eisenmenger syndrome - reversal of shunt which then goes R->L, causing bypass of lungs and cyanosis

Question 19

What is the normal heart configuration in Sequential Segmental Arrangement terminology?

Answer 19

Situs solitus
Concordant AV connection
Concordant ventriculo-arterial connection

Question 20

What makes up the Tetralogy of Fallot?

Answer 20

Large VSD
R ventricular outflow obstruction (pulmonary stenosis)
Overriding aorta
R ventricular hypertrophy