CHD

Question 1

Right atrial isomerism

Associations

Answer 1

Midline liver
Anomalous pulmonary venous return
Asplenia

Question 2

CXR in PAPVR

Answer 2

RAE, RVE, increased pulmonary vascular markings

Question 3

What is the tetralogy type VSD

Answer 3

Perimembranous infundibular

Question 4

Which VSDs associated with AR

Answer 4

Supracristal commonly

Perimembranous occasionally

Question 5

Which VSD most likely to close spontaneously

Answer 5

Small trabecular

Question 6

Which VSDs do not close spontaneously or get smaller

Answer 6

Inlet and infundibular

Question 7

Indication for VSD closure straight away

Answer 7

Qp:Qs greater than 2:1

CHF and growth retardation not responding to maximal med therapy

Large VSD and increasing PVR

Question 8

ECG in VSD

Small

Moderate

Large

PVOD

Answer 8

Normal

Moderate- LAH, LVH

Large- BVH, LAH

Purely RVH in PVOD

Question 9

Continuous murmur

Ddx

Answer 9

PDA (ULSE)
Coronary AV fistula (praecordium)
Systemic AV fistula (murmur over fistula)
Pulmonary AV fistula (back, cyanosis, clubbing, no cardiomegaly)
Venous hum
Collaterals
VSD + AR
To and fro after Tet repair
Aortopulmonary window

Question 10

ECG in complete ECD

Answer 10

Superior axis
RVH
RBBB
+/- LVH

Most have prolonged PR interval

Question 11

Superior axis on ECG

Answer 11

Primum ASD
ECD
Noonan
TA
Ebsteins (+ deficient RV forces)

Question 12

PS

Most common location for stenosis

Post stenotic dilation seen with which level of PS

Heart sounds

Answer 12

Valvular (90%)

Valvular

Click in valvular
Widely split S2
Quiet P2

Murmur radiates to back and axillae
Louder and longer more severe

Question 13

Most common cause of valvular AS

Answer 13

Bicuspid ao valve

Question 14

Supravalvular AS associated with…

Answer 14

Williams syndrome

Question 15

Coanda effect

Answer 15

Patients with supravalvular AS have higher BP in right arm due to jet of stenosis directed into inominate artery

Question 16

Ross procedure

Answer 16

Pulmonary valve replaces aortic valve

Homograft pulmonary valve

Question 17

Proportion of CoA with BAV

Answer 17

85%

Question 18

CoA

Sx in infancy

ECG

Answer 18

CHF
Renal failure 
Loud gallop
Thready pulses
No murmur 

Shows RVH and RBBB rather than LVH

Question 19

Type A interrupted arch

Answer 19

Distal to left subclavian artery (30%)

Question 20

Type B interrupted arch

Answer 20

Between left common carotid and left subclavian

(43%)

50% have 22q11.2 deletion syndrome

Question 21

Type C interrupted arch

Answer 21

Between inominate and left carotid

Almost all have PDA and VSD