Congenital Heart Disease

Question 0

What is atrial septal defect caused by?

Answer 0

Failure of the foramen ovale to close

Question 1

Name the acyanotic defects

Answer 1

Atrial septal defect
Patent foramen ovale
Ventricular septal defect
Patent ductus arteriosus
Coarctation of the aorta

Question 2

What happens to blood flow in ASD?

Answer 2

Blood flows from left to right atrium postnatally - no mixing of deoxygenated with oxygenated blood so is acyanotic

Question 3

What causes patent foramen ovale?

Answer 3

Higher left atrial pressure causes closure of the flap valve in the atrial wall

Question 4

What are effects if patent foramen ovale?

Answer 4

Generally clinically silent and may be present in 20% of population
May be the route by which a venous embolism reaches the systemic circulation if pressure on the right increases

Question 5

Where does the ventricular septal defect commonly occur?

Answer 5

In the membranous portion of the interventricular septum

Question 6

In which direction does blood flow in ventricular septal defect?

Answer 6

Left to right

Question 7

What causes patent ductus arteriosus?

Answer 7

Failure of the ductus arteriosus to close after birth.

In utero, it is there for blood to flow from pulmonary artery to the aorta

Question 8

Which direction does blood flow in PDA?

Answer 8

From aorta to pulmonary artery

Question 9

What can PDA lead to?

Answer 9

Vascular remodelling of the pulmonary circulation and an increase in pulmonary resistance

Question 10

What is Eisenmenger syndrome?

Answer 10

In PDA, if the pulmonary resistance increases to above that of the systemic circulation, the shunt will reverse direction and flow from the pulmonary artery to the aorta

Question 11

What does the ductus arteriosus become after birth?

Answer 11

Ligamentum arteriosum

Question 12

What causes coarctation of the aorta?

Answer 12

Narrowing of the aortic lumen in the region of the ligamentum arteriosum

Question 13

What does coarctation of the aorta lead to?

Answer 13

Increased afterload in the left ventricle ➡️ left ventricular hypertrophy
Reduced blood flow to the rest of the body (except for head and neck)

Question 14

Symptoms of coarctation of the aorta?

Answer 14

Weak and delayed femoral pulses

Upper body hypertension

Question 15

When do symptoms of coarctation of the aorta normally occur?

Answer 15

If severe - shortly after birth

If mild - adult life

Question 16

Name some cyanotic defects

Answer 16

Tetralogy of Fallot
Tricuspid atresia
Transposition of the great arteries
Hypoplastic left heart

Question 17

What are the four anomalies of Tetralogy of Fallot?

Answer 17

Ventricular septal defect
Overriding aorta
Pulmonary stenosis
Right ventricular hypertrophy

Question 18

What is overriding aorta?

Answer 18

When the aorta receives blood from both ventricles due to a ventricular septal defect.

Question 19

Which direction does the blood flow in Tetralogy of Fallot?

Answer 19

Right to left shunt

Question 20

What symptoms might affected individuals have in tetralogy of Fallot?

Answer 20

Cyanosis or spells of it during infancy

Mild cases can present in adulthood

Question 21

What is tricuspid atresia?

Answer 21

Lack of development of the tricuspid valve

Question 22

In tricuspid atresia, what must there be for blood to flow to the lungs?

Answer 22

Needs to be a complete right to left shunt of all blood returning to right atrium by an ASD or PFO and a VSD or PDA.

Question 23

What is transposition of the great arteries?

Answer 23

Right ventricle is connected to aorta
Left ventricle connected to the pulmonary trunk.
Results in two unconnected parallel circulations

Question 24

How is transposition of the heart arteries treated?

Answer 24

A shunt needs to be maintained or created immediately after birth until surgicalp correction can be made.
The ductus arteriosus can be maintained of an atrial septal defect formed.

Question 25

What is a hypoplastic left heart?

Answer 25

When the left ventricle and descending aorta fail to develop properly. A PFO or ASD are also present. Blood supply to systemic circulation is via a PDA

Question 26

What is cyanosis?

Answer 26

Abnormal blue discolouration of the skin and mucous membranes caused by an increase in deoxygenated haemoglobin.