Congenital Heart Defects

Question 1

List the congenital heart defects that cause cyanosis (3)

Answer 1

Tetralogy of Fallot
Truncus arteriosus
Transposition of the great arteries

Question 2

List the acyanotic congenital heart defects (4)

Answer 2

Patent ductus arteriosus (PDA)
Ventricular septal defect (VSD)
Atrioventriocular septal defect (AVSD)
Valve disorders

Question 3

What is the pathophysiology of acyanotic heart disorders?

Answer 3

They shunt blood from left to right

Question 4

What can occur in severe acyanotic heart disorders? (3)

Answer 4

Eisenmenger’s syndrome (cyanotic)
Reversal of an L-to-R shunt to a right to left shunt
(deoxygenated blood gets into the oxygenated circulation)

Question 5

How would you diagnose congenital heart defects?

Answer 5

Echocardiogram

Question 6

How would you treat congenital heart defects?

Answer 6

Surgery

Question 7

What are the clinical presentations of patients w congenital heart defects? (3)

Answer 7

Failure to thrive/ stunted growth in childhood
Finger clubbing
Syncope

Question 8

What is the tetralogy of Fallot? (4)

Answer 8

Overriding aorta
Pulmonary stenosis
Right ventricular hypertrophy
Large ventricular septal defect

Question 9

On examination, your patient has a loud, harsh ejection systolic murmur at the left lower sternal edge. What is this condition?

Answer 9

Tetralogy of Fallot

Question 10

What is the transposition of the great arteries (TGA)?

Answer 10

Aorta and pulmonary artery are swapped around

Question 11

What is a truncus arteriosus?

Answer 11

One single blood vessel coming from both the left and right ventricle (instead of a separate pulmonary artery and aorta)

Question 12

On chest auscultation, you hear a loud systolic murmur. What condition is this?

Answer 12

Ventricular septal defect

Question 13

On examining a patient’s chest, you hear a continuous machinery murmur. What condition is this?

Answer 13

Patent ductus arteriosus

Question 14

What is a common cause of valve disease?

Answer 14

Rheumatic fever via strep pyogenes (rare now)

Question 15

How would a patient with aortic stenosis present? (4)

Answer 15

Angina
Heart failure
Loss of consciousness on exertion

LVH

Question 16

What would you hear on chest examination of a patient with aortic stenosis?

Answer 16

Ejection systolic murmur (crescendo-decrescendo)

Question 17

What are the clinical presentations of a patient with aortic regurgitation? (3)

Answer 17

Palpitations and dyspnoea on exertion
Angina
Collapsing (water hammer) pulse

Question 18

What would you hear on chest examination of a patient with aortic regurgitation?

Answer 18

Early diastolic/ Austin Flint murmur

Question 19

What are the clinical presentations of a patient with mitral stenosis?

Answer 19

Progressive SOB
Fatigue
Palpitations

Question 20

What would you hear on chest examination of a patient with mitral stenosis?

Answer 20

Rumbling mid-diastolic murmur

Question 21

What are the clinical presentations of a patient with mitral regurgitation? (3)

Answer 21

SOB on exertion
Fatigue
Palpitations

Question 22

What would you hear on chest examination of a patient with mitral regurgitation?

Answer 22

Pansystolic murmur at apex readiating to axilla

Question 23

How would you differentiate mitral stenosis and mitral regurgitation on CXR?

Answer 23

CXR mitral stenosis: LA enlargement

CXR mitral regurgitation: LA and LV enlargement