Cardiovascular

Question 1

Clinical/Presenting Features of Coarctation of the Aorta?

Answer 1

1st day examination is usually normal, followed by:

• Sick baby with severe heart failure
• Absent femoral pulses
• Severe metabolic acidosis
• Cardiomegaly (ECG will be normal)

Question 2

What are the three cyanotic heart defects?

Answer 2

o Tetralogy of Fallot
o Transposition of Great Arteries
o AVSD

Question 3

What are the five acyanotic heart defects?

Answer 3

o VSD 
o ASD 
o Patent Ductus Arteriosus
o Pulmonary stenosis 
o Aortic stenosis

Question 4

What kind of shunting do cyanotic heart defects involve?

Answer 4

Right to left shunt with mixing

Question 5

What kind of shunting do acyanotic heart defects involve?

Answer 5

Left to right shunting +/- outflow obstruction

Question 6

What are the clinical features of VSDs?

Answer 6

Small VSDs
o Asymptomatic
o Physical signs
▪ Loud pansystolic murmur at LLSE
▪ Quiet pulmonary 2nd sound (P2)

Large VSDs
o Symptoms
▪ Heart failure with breathlessness and FTT after 1 week old
▪ Recurrent chest infections
o Physical signs
▪ Tachypnoea, tachycardia & enlarged liver (heart failure)
▪ Active precordium
▪ Soft pansystolic murmur or no murmur
▪ Apical mid-diastolic murmur - due to increased flow across mitral valve

Question 7

What are the clinical features of patent Ductus Arteriosus?

Answer 7

• Continuous murmur beneath left clavicle
• Collapsing/bounding pulse
• Pulmonary hypertension
• Murmur continues into diastole because the pressure in the pulmonary artery is lower than that in the aorta throughout the cardiac cycle ->
  the PP is increased, causing collapsing or bounding pulse