Congenital Heart Disease

Question 1

Classification of congenital heart diseases

Answer 1

1. Obstruction to blood flow - coarctation of aorta, pulmonary/aortic stenosis & atresia - acyanotic
2. Abnormal shunting of blood
   - L to R shunt - potentially cyanotic
   - R to L shunt - cyanotic

Question 2

L to R shunts (3)

Answer 2

1. ASD
   - R sided vol overload - excessive flow through pulm valve - ejection systolic murmur
2. VSD
   - asymptomatic/R ventricular hypertrophy & pulmonary htn - irreversible pulm vascular disease - shunt reversal (Eisenmenger syndrome)
   - pan systolic murmur
3. PDA
   - progressive obstructive changes in pulm vasculature - due to pulm vol overload
   - continuous/harsh/machinery like murmur

Question 3

R to L shunts

Answer 3

Tetralogy of Fallot

1. VSD
2. Overriding aorta
3. Pulmonary stenosis - narrowing of RV outflow tract
4. RV hypertrophy - deal w increased obstruction

Question 4

Complications of congenital heart disease (3)

Answer 4

1. Heart failure
2. Shunt reversal
3. Infective endocarditis
   - abnormal blood flow, turbulence - infection is more likely to seed at sites of abnormality - higher chance of thrombus formation - meshwork for infection