Chapter 52 - Congenital cardiovascular disease

Question 1

What are the two major categories of congenital heart disease?

Answer 1

1. shunting defects. 2. perivalvular defects

Question 2

What is Eisenmenger’s syndrome?

Answer 2

Eisenmenger’s syndrome (or ES, Eisenmenger’s reaction, Eisenmenger physiology, or tardive cyanosis) is defined as the process in which a long-standing left-to-right cardiac shunt caused by a congenital heart defect (typically by a ventricular septal defect, atrial septal defect, or less commonly, patent ductus arteriosus) causes pulmonary hypertension[1][2] and eventual reversal of the shunt into a cyanotic right-to-left shunt.

Question 3

What is Tetralogy of Fallot?

Answer 3

It’s a constellation of a VSD, overriding aorta, pulmonic stenosis, resultant right ventricular hypertrophy.

Question 4

Reverse PDA is postulated to occur either _________ or _________.

Answer 4

1. retained fetal circulation and persistence of high pulmonary vascular resistance
2. endothelial response to pulmonary over circulation and resultant pulmonary hypertension.

Question 5

What was the author’s preferred target PCV of phlebotomy for the polycythemic patient?

Answer 5

Preferred target 60%, and caution that further reduction below 60% usually results in clinical decompensation.