Cardiology - Congenital causes

Question 1

Drugs contraindicated in HCM

Answer 1

• Inotropes
• Vasodilators, such as dihydropyridine calcium channel blockers (e.g., nifedipine, amlodipine)
• Nitroglycerin
• Angiotensin-converting enzyme inhibitors
• Angiotensin II receptor blockers
• Diuretics
• Digoxin

Note:
Allowed: negative inotropes/chronotropes: β-blockers, CCB
(verapamil), disopyramide

MCQs

Question 2

Causes of congenital acyanotic heart disease

Answer 2

With shunts:

• Aortic coarctation (with VSD or PDA),
• VSD,
• ASD,
• PDA,
• Partial anomalous venous drainage (with ASD)

Without shunts:

• Congenital AS,
• Aortic coarctation

Question 3

Causes of cyanotic heart disease

Answer 3

With shunts:

• Tetralogy of Fallot (VSD),
• Severe Ebstein’s anomaly (ASD),
• Complete transposition of great vessels (ASD, VSD/PDA)

Without shunts:

• Tricuspid atresia,
• Severe pulmonary stenosis,
• Pulmonary atresia,
• Hypoplastic left heart

MCQs

Question 4

Eisenmenger syndrome

Answer 4

• VSD (Eisenmenger’s complex)
• ASD
• PDA

Question 5

Cardiac complications of Down’s syndrome

Answer 5

• Endocardial cushion defect (most common, 40%, also known as atrioventricular septal canal defects)
• Ventricular septal defect (c. 30%)
• Secundum atrial septal defect (c. 10%)
• Tetralogy of Fallot (c. 5%)
• Isolated patent ductus arteriosus (c. 5%)

Question 6

Dextrocardia associations

Answer 6

• Kartagener’s syndrome – situs inversus, bronchiectasis and sinusitis
• Asplenia
• Turner’s syndrome
• Cardiac malformations