Congenital Heart Disease

Question 1

what causes the closure of the oval foramen after a neonate is born?

Answer 1

increased left atrial pressure pressing on the valve

Question 2

what causes the closure of the ductus arteriosus in neonates?

Answer 2

bradykinin and decreased prostaglandins act on the wall

Question 3

what is the most common congenital heart defect?

Answer 3

bicuspid aortic valve (marfan’s)

Question 4

lesions that allow circulation of deoxygenated blood in the systemic circulation via shunting

Answer 4

cyanotic CHD

Question 5

oxygenated blood from the left to the right heart

Answer 5

acyanotic CHD

Question 6

what can obstructive lesions lead to? (2)

Answer 6

ventricular hypertrophy
heart failure

Question 7

what is an example of a cyanotic CHD?

Answer 7

tetralogy of fallot

Question 8

what is an example of a left and right sided obstruction?

Answer 8

coarctation of the aorta

Question 9

in large atrial septal defects, infants will present with what?

Answer 9

right-sided heart failure

Question 10

what are 2 common symptoms in adults age 40 in uncorrected defects?

Answer 10

atrial arrhythmias
exercise intolerance

Question 11

on physical, you hear a widely split S2. After heart failure develops, you hear a 4th heart sound. what could this be?

Answer 11

atrial septal defect

Question 12

what is the diagnostic test of choice for atrial septal defect?

Answer 12

echocardiogram

Question 13

what would an ECG show to indicate atrial septal defect?

Answer 13

crochetage pattern

Question 14

what size atrial septal defect at diagnoses is unlikely to spontaneously close?

Answer 14

over 8-10 mm

Question 15

what is the first line treatment for atrial septal defect? (2)

Answer 15

anticoags
cardioversion

Question 16

what treatment for atrial septal defect can be considered for adults with severe pulmonary vascular disease?

Answer 16

vasodilator

Question 17

what is the second line treatment for a repaired atrial septal defect?

Answer 17

antibiotics

Question 18

what type of atrial septal defects should be closed in children?

Answer 18

secundum >8mm in children older than 2 years

Question 19

what is the standard treatment for a sinus venosus, coronary sinus, or primum atrial septal defect?

Answer 19

surgical repair

Question 20

what is the treatment of choice of secundum atrial septal defect in adults?

Answer 20

percutaneous closure

Question 21

closure of an atrial septal defect is not indicated in patients who have developed irreversible _____ _____

Answer 21

pulmonary hypertension

Question 22

congenital or acquired defect of the interventricular septum that allows communication of blood between the left and right ventricles

Answer 22

ventricular septum defect

Question 23

ventricular septal defect can occur as a complication of what?

Answer 23

acute MI

Question 24

prolonged left to right shunting of blood in ventricular septal defect can lead to _____ _____

Answer 24

pulmonary hypertension

Question 25

a triad of left to right shunting, pulmonary arterial disease, and cyanosis

Answer 25

eisenmenger syndrome

Question 26

an infant that typically appears asymptomatic, now presents with respiratory distress, tachypnea, tachycardia, diaphoresis with feeds, and poor weight gain. what are they likely experiencing?

Answer 26

ventricular septal defect

Question 27

what is the diagnostic test to use for ventricular septal defect?

Answer 27

cardiac catheterization

Question 28

what is the treatment for ventricular septal defects? (2)

Answer 28

diuretics ACE inhibitor

Question 29

what can an infant develop due to ventricular septal defect?

Answer 29

anemia

Question 30

when should antibiotics be used for ventricular septal defect? (2)

Answer 30

complex cyanotic heart disease during first 6 mo after surgery

Question 31

what medications can be used for ventricular septal defect in an adult? (2)

Answer 31

digoxin diuretics

Question 32

what is the treatment for ventricular septal defect if the infant has pulmonary HTN, failure to thrive, and flow is poorly controlled?

Answer 32

VSD patch or repair

Question 33

what is a common complication after surgery for a ventricular septal defect?

Answer 33

RBBB

Question 34

persistence of the fetal communication between the descending aorta and main pulmonary artery

Answer 34

patent ductus arteriosus

Question 35

what is the diagnostic of choice for patent ductus arteriosus?

Answer 35

echocardiogram with doppler

Question 36

what medication is indicated to treat patent ductus arteriosus?

Answer 36

NSAIDS

Question 37

how do NSAIDS close a patent ductus arteriosus?

Answer 37

inhibit local prostaglandin synthesis

Question 38

when is antibiotic prophylaxis recommended for patent ductus arteriosus?

Answer 38

previous endocarditis

Question 39

when is PDA closure considered? (2)

Answer 39

volume overload signs of pulmonary HTN

Question 40

what condition leads to left ventricular pressure overload, myocardial hypertrophy, and heart failure if left untreated?

Answer 40

coarctation of the aorta

Question 41

a patient presents with lower limb claudication, syncope, chest pain, irritability, poor feeding in infant, and diaphoresis. what are they likely experiencing?

Answer 41

coarctation of the arota

Question 42

a patient presents with brachial-femoral delay, prominent neck pulsations, and bruit and palpable pulsation in the intercostal spaces. what are they likely experiencing?

Answer 42

coarctation of the aorta

Question 43

along with brachial-femoral delay, this patient also presents with underdevelopment of lower extremities in CoA. what age group are they?

Answer 43

older children/adults

Question 44

along with brachial-femoral delay, this patient presents with tachypnea, prominent right ventricular impulse, hepatomegaly, and cyanotic skin. what age group are they?

Answer 44

infant

Question 45

what is the diagnostic of choice for CoA?

Answer 45

echo

Question 46

what is the treatment for CoA until repair is complete?

Answer 46

alprostadil (prostaglandin E1)

Question 47

why should we treat CoA with alprostadil?

Answer 47

to maintain patency of ductus arteriosus in infancy

Question 48

what are the four features of tetralogy of fallot?

Answer 48

ventricular septal defect pulmonary valve stenosis aorta that overrides (rightward) RV hypertrophy

Question 49

what is the most common cyanotic malformation to reach adulthood without reparative surgery?

Answer 49

tetralogy of fallot

Question 50

a patient presents with low birth weight, dyspnea on exertion, squatting after exercise, cyanosis of nail beds and lips, digital clubbing and palpable RV impulse. what are they likely experiencing?

Answer 50

tetralogy of fallot

Question 51

a symptom of paroxysmal episodes of worsening cyanosis and rapid, deep breathing, noticed after feeding and defecation

Answer 51

tet spell

Question 52

what is used to diagnose tetralogy of fallot?

Answer 52

echo

Question 53

what would a chest radiography show when looking at tetralogy of fallot?

Answer 53

boot-shaped heart

Question 54

what is the treatment for tetralogy of fallot? (3)

Answer 54

oxygen prostaglandins knee-chest position during hypoxemic spells

Question 55

what is the acute treatment for tetralogy of fallot? (4)

Answer 55

phenylephrine oxygen morphine propranolol

Question 56

what are 2 surgical treatments for tetralogy of fallot?

Answer 56

complete surgical repair palliative surgery