congenital heart disease

Question 1

what are the different types of ventricular septal defects?

Answer 1

sub pulmonary
membranous
AV canal type
Muscular

Question 2

what does the haemodynamics of VSD depend on ?

Answer 2

pulmonary artery pressure
size of the defect/hole
does not depend on location

Question 3

what type of murmur is associated with VSD ?

Answer 3

pan systolic murmur

Question 4

what is the difference in presentation with a large VSD and a smaller VSD ?

Answer 4

a large VSD presents late and presents with heart failure

a small VSD presents early due to the loud pansystolic murmur

Question 5

how can VSD be diagnosed and what is the treatment ?

Answer 5

diagnosis : trans-thoracic echo

treatment: surgery between 3-6 months

Question 6

when does eisenmenger syndrome occur ?

Answer 6

when a large VSD is left untreated the shunt goes from being left to right
to becoming right to left
( higher pressure where the deoxygenated blood is)

Question 7

what type of murmur is associated with eisenmenger syndrome ?

Answer 7

short ejection pansystolic murmur

Question 8

what does the chest X-ray of a large VSD show ?

Answer 8

increased cardio-thoracic ratio
left ventricular dilatation
lung plethora

Question 9

what are the complications of left to right shunts ( large VSD ) ?

Answer 9

recurrent chest infections 
CHF
eisenmenger syndrome 
Infective endocarditis 
Arrhythmia

Question 10

what is the medical treatment for VSD ?

Answer 10

potassium sparing diuretics to decrease the volume overload

captopril

Question 11

what are the indications for surgical repair of VSD ?

Answer 11

intractable CHF 
growth failure despite medical therapy 
Large VSD ( 3-6 months of age )

Question 12

what does the haemodynamic of the ASD depend on ?

Answer 12

size of the ASD

compliance of the right ventricle

Question 13

what is the most common type of ASD ?

Answer 13

secundum type where the foramen ovale is patent

Question 14

what are the clinical signs of heart failure ?

Answer 14

tachypnea
tachycardia
stunted growth

Question 15

what is heard on auscultation of an atrial septal defect (patent formane ovale )

Answer 15

fixed splitting of the second heart sound

Question 16

is ASD cyanotic or acyanotic ?

Answer 16

Acyanotic

Question 17

which clinical finding is not commonly associated with ASD ?

Answer 17

heart failure due to good heart elasticity

Question 18

what are the haemodynamics behind PDA ?

Answer 18

similar to VSD - associated with volume overload in the left ventricle

Question 19

which congenital heart defect is most commonly associated with preterm babies ?

Answer 19

Patent Ductus Arteriosus

Question 20

what type of murmur is associated with PDA ?

Answer 20

continuous systolic murmur ( infraclavicular)

Question 21

what are the three management options for PDA ?

Answer 21

conservative/Supportive management
Pharmacotherapy ( indomethacin, paracetamol, ibuprofen)
Surgery ( only if the previous two methods have failed)

Question 22

which genetic abnormality is highly associated with CHD ?

Answer 22

down syndrome

Question 23

what is AVSD a defect inn ?

Answer 23

endocardial cushion

Question 24

what is the correlation between hypertrophy and heart failure ?

Answer 24

the more hypertrophy there is the less the chances of occurence of HF

Question 25

what is heard on auscultation in the case of an AVSD ?

Answer 25

regurgitation with a systolic murmur best heard over the apex

Question 26

what features aid in the diagnosis of AVSD ?

Answer 26

plethora on the lungs | enlarged heart

Question 27

what genetic abnormality is commonly associated with pulmonary valve stenosis ?

Answer 27

noonan syndrome

Question 28

what is the presentation nof pulmonary valve stenosis ?

Answer 28

baby with CRITICAL PVS presents with HF and mild cyanosis

Question 29

what is the treatment for pulmonary stenosis ?

Answer 29

balloon dilatation or surgery

Question 30

what are the three levels of blockage that could cause aortic stenosis ?

Answer 30

valvular subvalvular supravalvular

Question 31

what is subvalvular stenosis in aortic stenosis usually associated with ?

Answer 31

fibrous rings

Question 32

what is supravalvular stensosis inn naortic stenosis usually associated with ?

Answer 32

multisystem disorder

Question 33

what is heard on auscultation with valvular stenosis ?

Answer 33

systolic click

Question 34

what are the clinical features of aortic stenosis ?

Answer 34

LV hypertrophy | systolic murmur

Question 35

what are the clinical features of aortic coartication ?

Answer 35

hypotension late systolic murmur over the back absent femoral pulse

Question 36

what are the four abnormalities associated with teratology of fallot ?

Answer 36

pulmonary stenosis right ventricular hypertrophy ( due to pressure overload) ventricular septal defect overriding aorta

Question 37

what is the pathology associated with the teratology of fallot ?

Answer 37

shifting of the septum towards the right ventricle

Question 38

what is heard on auscultation in TOF ?

Answer 38

single and accentuated second heart sound | systolic ejection murmur

Question 39

which clinical feature does a TOF patient never experience ?

Answer 39

recurrent chest infections

Question 40

what is the clinical presentation of teratology of fallot ?

Answer 40

cyanosis within the first few months of life hypoxic spells clubbing

Question 41

what is the pathology in D-TGA ?

Answer 41

the pulmonary artery and the aorta have switched positions ( +/- VSD )

Question 42

what is the treatment for D-TGA ?

Answer 42

arterial switch operation