Congenital heart disease

Question 1

Three risk factors for congenital heart disease?

Answer 1

genetic
gestational diabetes
drugs during pregnancy
infections
alcohol
smoking

Question 2

What is the presentation of congenital heart disease?

Answer 2

hypoxia
tachyopnoea
tachycardia
cyanosis
poor weight gain
failure to thrive

Question 3

Which murmur does atrial septal defect result in?

Answer 3

soft ejection systolic murmur at upper left sternal border

Question 4

Which conditions are ventricular septal defect associated with?

Answer 4

down’s syndrome
edward’s syndrome
patau’s syndrome

Question 5

Which murmur is associated with ventricular septal defect?

Answer 5

systolic murmur lower left sternal edge

Question 6

Which shunt is present in ventricular septal defect?

Answer 6

left to right but can reverse if pulmonary hypertension occurs

Question 7

Which abnormality is present in coarctation of the aorta?

Answer 7

narrowing of aorta distal to the origin of the left subclavian vein

Question 8

Which condition is coarctation of the aorta associated with that might leave you prone to haemorrhage?

Answer 8

berry aneurysm

Question 9

Name one key sign of coarctation of the aorta

Answer 9

radio-femoral delay

Question 10

What happens to the blood pressure and appearance of skin colour in coarctation of the aorta?

Answer 10

BP higher in upper limbs vs lower

upper body pink vs lower body cyanosed

Question 11

Which condition is patent ductus arteriosus associated with?

Answer 11

down’s syndrome

Question 12

What are the four features of tetralogy of fallot?

Answer 12

VSD
Overriding aorta
pulmonary stenosis
right ventricular hypertrophy

Question 13

Which is the most common congenital heart condition?

Answer 13

congenital bicuspid aortic valve

Question 14

Which genetic condition is bicuspid aortic valve associated with?

Answer 14

turner’s syndrome

Question 15

Which murmur is present with coarctation of the aorta?

Answer 15

systolic murmur in left infraclavicular area

Question 16

Which murmur is present in patent ductus arteriosus?

Answer 16

continuous machinery murmur at upper left sternal border

Question 17

What is Eisenmenger’s syndrome?

Answer 17

obstructive pulmonary vascular disease causing pulmonary hypertension, right to left shunt

Question 18

What are the signs of Eisenmenger’s syndrome?

Answer 18

dyspnoea
syncope
cyanosis
finger clubbing
right ventricular heave

Question 19

Which heart sound is present in Eisenmenger’s syndrome?

Answer 19

loud second heart sound with narrow split

Question 20

What is the management of Eisenmenger’s syndrome?

Answer 20

1. avoid smoking, dehydration, pregnancy, excessive physical activity
2. treat HF
3. treat arrhythmias
4. heart/lung transplant

Question 21

Why does polycythaemia vera arise in Eisenmenger’s syndrome?

Answer 21

in response to the right to left shunt causing poor oxygenation of RBCs leading to cyanosis. In response, the bone marrow produces more RBCs and Hb to correct this imbalance. This leads to a high concentration of Hb in the blood.

Question 22

Why are people with Eisenmenger’s syndrome prone to cerebrovascular events?

Answer 22

the high concentration of Hb causes blood to become more viscous

Question 23

Which lesions of the heart are associated with Eisenmenger’s syndrome?

Answer 23

Atrial septal defect
Ventricular septal defect
Patent ductus arteriosus

Question 24

How is polcythaemia treated in Eisenmenger’s syndrome?

Answer 24

venesection

Question 25

Which complications of congenital heart disease are patients at risk of?

Answer 25

thromboembolism
infective endocarditis
arrythmias

Question 26

The combined oral pill is contraindicated in which congenital heart conditions?

Answer 26

Eisenmenger’s syndrome

Primary pulmonary hypertension

Question 27

Name two cardiac conditions in which pregnancy is contraindicated?

Answer 27

severe aortic stenosis
severe mitral stenosis
severe LVSD
primary pulmonary hypertension
marfan's syndrome

Question 28

Which is the most common type of atrial septal defect?

Answer 28

secundum= It occurs in the middle of the wall between the upper heart chambers (atrial septum).

Question 29

Berry aneuysms are associated with which congenital heart condition?

Answer 29

coarctation of the aorta