Congenital heart defects

Question 1

ASD

Answer 1

Wide, fixed split-second heart sound

Ejection systolic murmur second, third intercostal space

Question 2

Harsh pansystolic murmur left sternal edge

Answer 2

VSD

Question 3

Radiofemoral delay- what is the condition, what is the sign/symptom you will see with that condition

Answer 3

CoA, Hypertension in kid

Turner’s

Question 4

Continous “machinery” murmur below left clavicle

Answer 4

PDA

Question 5

Cyanosis first day of life

CXR- egg-on string

Answer 5

Transposition of the great vessels

X-ray showing characteristic finding in case of Transposition of the great vessels which is called egg on side sign

Question 6

Cyanosis first month of life

CXR- boot-shaped heart

Answer 6

Tetralogy of Fallot

Question 7

The “3 Ds” of acyanotic CHDs

Answer 7

VSD, ASD, PDA.

Question 8

Persistence of the foramen ovale beyond 1 year of age- PFO increases the risk of

Answer 8

Paradoxical embolism
Systemic embolisms (e.g., renal infarction)
Stroke

Question 9

What can you give to keep the PDA open

Answer 9

Pharmacologic closure (in premature infants): Infusion of indomethacin or ibuprofen (pharmacologic closure) can induce the closure of the ductus

In utero, prostaglandin is responsible for keeping the ductus patent. Inhibiting the prostaglandin synthesis with indomethacin or ibuprofen induces the closure of the ductus in preterm infants. Indomethacin is contraindicated in the case of intraventricular hemorrhage.

Question 10

Why would you keep the PDA open and how would you do that

Answer 10

Administer prostaglandin (PGE1) if the PDA is needed for survival (e.g., in the transposition of the grand vessels, tetralogy of Fallot, hypoplastic left heart).

Question 11

4 features of TOF

Answer 11

Right ventricular outflow obstruction (RVOT) due to pulmonary valve stenosis 
Right ventricular hypertrophy(RVH)
Ventricular septal defect (VSD)
Overriding aorta (above the VSD)

Question 12

What is the most common cyanotic heart disease

Answer 12

TOF

Question 13

Congenital heart defect, what should you rule out

Answer 13

Without treatment, 95% of patients with hypoplastic left heart syndrome die within their first month of life!

Question 14

What condition do you get when exposured to lithium during pregnancy

Answer 14

Ebstein anomaly

Malformed and displaced tricuspid valve leaflets causing tricuspid valve regurgitation and right heart enlargement

Question 15

The most common innocent murmur in children; unknown etiology

Answer 15

Still’s murmur- it is a systolic ejection murmur

other innocent murmurs are venous hum and pulmonary flow murmur

Question 16

Pathological murmur- radiates to the back, associated with SOB

Answer 16

Pulmonary stenosis

Question 17

Better with squatting(Tet spells)

Answer 17

TOF