Congenital Heart Defects

Question 1

What is worse L to R shunt or R to L shunt?

Answer 1

R to L shunt is worse

Question 2

What is the most frequent congenital defect

Answer 2

VSD

Question 3

What are the Left to Right shunts

Answer 3

VSD
ASD
PDA

Question 4

What can uncorrected L to R shunt lead to?

Answer 4

Eisenmenger syndrome

–> increased pulmonary hypertension –> RVH—> R to Left shunt

late cyanosis, clubbing, polycythemia

Question 5

Harsh Holosystolic murmur

Answer 5

VDA

Question 6

Loud S1, wide fixed S2

Answer 6

ATrial septal defect

Question 7

MCC of ASD

Answer 7

Ostium secundum defect

foramen ovale + foramun secundum overlap so don’t close

Question 8

Continuous “machine- like murmur”

Answer 8

PDA

Question 9

When do you want PDA? How you make it

Answer 9

Transposition of great vessels

go PGE

Question 10

Increase BP in upper extremities

Lower BP in lower extremities

Answer 10

Coarctation of aorta

Question 11

Notching of Ribs

Answer 11

Coarctation of aorta

Question 12

Aortic regurgitation

Answer 12

Coarctation of aorta

Question 13

What are the 5 Right to Left shunts?

Answer 13

5T’s

1. Truncus arteriosus (1 vessel)
2. Transposition (2 vessels)
3. Tricuspid atresia (3 vessels)
4. Teratalogy of Fallot (4 vessels)
5. TAPVR (5 in name)

Question 14

What do you usualy have with a Persistant truncus arteriosus?

Answer 14

VSD

Question 15

What is Tricuspi atresia?

Answer 15

Absence of tricuspid valve and hypoplastic RV

Question 16

What is required for Tricuspid atresia for viability

Answer 16

both ASD and VSD required for viability?

Question 17

TERATOLOGY OF FALLOT

Answer 17

IHOP
VSD
HYPERTROPHY OF RV
Overriding aorta
Pulmonary stenosis

Question 18

Boot shaped heart on CSR

Answer 18

Kids- RVH maybe teratology of Fallot

Adults- COPD

Question 19

If you have Teratology of fallot what improves cyanosis?

Answer 19

Squatting increases SVR decreases right to left shunt

but do surgery to treat

Question 20

What is total anomalous pulmonary venous return

Answer 20

Pulmonary veins drains into right heart circulation (CVS, coronary sinus, etc);

associated with ASD sometimes PDA to allow for R to L shunting to maintain CO

Question 21

MC congenital cause of early cyanosis

Answer 21

Teratology of Fallot

Question 22

Chromosome 22q11 deletion

Answer 22

Truncus arteriosus, teratology of fallot

btw this is DiGeorge syndrome

Question 23

Down syndrome

Answer 23

Endocardial cushion defect

like ASD or VSD, center of

Question 24

Congenital Rubella

Answer 24

PDA or pulmonary artery stenosis

Question 25

Turner syndrome

Answer 25

Coarctation of aorta, bicuspid aortic valve

Question 26

Diabetic mom

Answer 26

Transposition of great vessels

Question 27

Alcoholic exposure

Answer 27

VSA, PDA, ASD, teratology of Fallot