CONGENITAL HEART DISEASE

Question 1

Types of congenital heart disease

Answer 1

Cyanotic
Acyanotic

Question 2

Examples of cyanotic heart disease

Answer 2

Tetralogy of Fallot (TOF)
Transposition of the great arteries (TGA)

Question 3

Examples of acyanotic heart disease

Answer 3

Ventricular septal defect
Atrial septal defect
Patent ductus arteriosus
Aortic stenosis
Pulmonary stenosis
Coarctation of the aorta

Question 4

Which type of congenital heart disease involves mixing of oxygenated and deoxygenated blood

Answer 4

Cyanotic

Question 5

Causes of congenital heart disease

Answer 5

Idiopathic
Genetics
Maternal infections
Maternal diabetes
Alcohol
Smoking
Drugs
Exposure to X-rays during early pregnancy
Prematurity
Multiple pregnancy

Question 6

Maternal infections associated with congenital heart disease

Answer 6

Viral infections such as rubella virus

Question 7

Symptoms common to acyanotic and cyanotic heart disease

Answer 7

Easy fatiguability
Breathlessness
Poor feeding
Poor growth
Cold sweat on forehead
Puffy eyelids
Swollen feet
Distended abdomen
Chest pain, syncope or death on exertion

Question 8

Signs of congenital heart disease not common infants

Answer 8

Edema (puffy eyelids, swollen feet)

Question 9

Signs of congenital heart disease common in both cyanotic and acyanotic heart disease

Answer 9

Cold sweaty skin
Puffy eyelids
Distended neck veins and ankle oedema (in older children)
Tachycardia
Tachypnoea
Weak thready pulse
Cardiomegaly
Gallop rhythm
Crepitations, rhonchi
Hepatomegaly
Heart murmur

Question 10

Signs seen in only cyanotic heart disease

Answer 10

Finger clubbing
Cyanosis
Heart murmur
Hypercyanotic attack

Question 11

What is hypercyanotic attack

Answer 11

respiratory distress with deepening cyanosis, loss of consciousness and convulsions

Question 12

Signs of cyanosis

Answer 12

Blue tongue and fingernails

Question 13

Symptoms seen in only cyanotic heart disease

Answer 13

Cyanosis
Squatting several times during play in toddlers

Question 14

Why is squatting seen in cyanotic heart disease

Answer 14

The squat increases peripheral resistance in the lower extremities, shunting blood towards more vital organs

Question 15

Investigations in congenital heart disease

Answer 15

FBC
ECG
Echocardiography
Chest X-rayT

Question 16

Treatment objectives in congenital heart disease

Answer 16

Early recognition of the problem
Prompt treatment of heart failure
Early surgical correction if indicated
Prevention of endocarditis

Question 17

When is oxygen given in congenital heart disease and at what rate

Answer 17

In hypercyanotic attack
By face mask or nasal prongs, 2L/minute

Question 18

Role of propranolol in treatment of congenital heart disease

Answer 18

To improve blood flow into lungs for patients with Tetralogy of Fallot

Question 19

Dose of propranolol in TOF

Answer 19

Propranolol, oral,
Children 1 month-12 years
0.25-1 mg/kg 6-8 hourly (max. 5 mg/kg daily)
Neonates
0.25-1 mg/kg 8-12hourly (max. 2mg/kg 8 hourly)

Propranolol, slow IV with ECG monitoring,
Children 1 month - 12 years
15-20 microgram/kg 6-8 hourly (max. 200 microgram/kg) repeated
every 6-8 hours if necessary
Neonates
15-20 microgram/kg (max. 100 microgram/kg) repeated every 12 hours if necessary