Cardiovascular Diseases: High Yield Concepts in Congenital Heart Diseases (CHD)

Question 1

Most common congenital heart disease; CXR shows biventricular enlargement & dilated left atrium; most common type is membraneous

Answer 1

Ventricular Septal Defect (VSD)

Question 2

Most common congenital heart disease diagnosed in adults; CXR shows dilated right atrium and right ventricle

Answer 2

Atrial Septal Defect (ASD)

Question 3

CHD with Early Cyanosis (R—>L shunt)

Answer 3

Mnemonic: All CHDs that start with “T”:
- Tetralogy of Fallot (TOF)
- Tricuspid Atresia
- Truncus Arteriosus
- Total Anomalous Pulmonary Venous Connection
(TAPVC)
- Transposition of the Great Arteries (TGA)

Question 4

CHD with Late Cyanosis (L—>R shunt)

Answer 4

ASD, VSD, PDA, AVSD

Question 5

Conversion of an initial L—>R shunt into a R—>L shunt

Answer 5

Eisenmengerization

Question 6

CHD associated with Congenital Rubella Syndrome; “continuous machinery like murmur”; needs indomethacin to close and PGE1 to remain open

Answer 6

Patent Ductus Arteriosus (PDA)

Question 7

CHD associated with Turner’s Syndrome

Answer 7

Preductal Coarctation of the Aorta (CoA)

Question 8

CHD associated with Down Syndrome

Answer 8

ASD, Endocardial Cushion Defect

Question 9

CHD associated with Marfan Syndrome

Answer 9

MVP, Aortic Dissection

Question 10

CHD associated with offspring of diabetic moms

Answer 10

TGA

Question 11

CXR shows boot-shaped heart (Coeur en Sabot); Components: subpulmonic stenosis (main determinant of severity), RVH, VSD, overriding of the aorta

Answer 11

TOF

Question 12

CXR shows egg-shaped silhouette or egg-on-its-side apperance

Answer 12

TGA

Question 13

CXR shows snowman sign / cottage-loaf heart

Answer 13

TAPVC

Question 14

CXR shows figure of 3 sign

Answer 14

CoA (rib-notching is seen in the adult or post ductal form)