Congenital Heart Disease

Question 1

What results in cyanosis

Answer 1

mixing of blood from the right heart to the left heart (but not left to right)

Question 2

The four T’s of early cyanosis/mixing

Answer 2

Tetrology, Transposition of the great arteries, Truncus arteriosus, and Tricuspid atresia

Question 3

Describe how late/tardive cyanosis occurs.

Answer 3

With abnormal openings (ASD, VSD, or PDA), blood flow is initially from left to right. As the right heart hypertrophies secondary to increased flow and pressures, the right heart pressures will eventually reverse the flow from right to left

Question 4

Simple shunting congenital heart diseases

Answer 4

ASD, VSD, PDA

Question 5

Valve blockage congenital heart diseases

Answer 5

Tricuspid stenosis/atresia, pulmonic stenosis/atresia, aortic stenosis/atresia

Question 6

Major defective congenital heart diseases

Answer 6

Tetrology of Fallot, persistent truncus arteriosus, Transposition ofthe great arteries, malpositions of the heart

Question 7

Outflow obstructive congenital heart diseases

Answer 7

coarctation of the aorta, cor pulmonale

Question 8

Maternal rubella is associated with

Answer 8

PDA, pulmonic valvular or arterial stenosis, Tetralogy of Fallot, VSD, cataracts, deafness, microcephaly

Question 9

Right to left shunts can cause

Answer 9

Cyanosis (clubbing, hypertrophic osteoarthropathy, polycythemia
Embolic (brain abscesses, thrombosis)

Question 10

Clinical consequences of congenital heart diseases

Answer 10

Right to left shunts
Right heart failure
Left heart failure
Obstruction to flow
Infective endocarditis

Question 11

Murmur of VSD

Answer 11

pansystolic murmur over lower left sternal border

Question 12

Three types of ASDs

Answer 12

ostium primum (Down's syndrome)
ostium secundum (90%)
sinus venosus

Question 13

Murmur of ASD

Answer 13

systolic ejection murmur related to the pulmonic valve, split S2

Question 14

Murmur of a PDA

Answer 14

continuous harsh (“machine like”) murmur

Question 15

stenosis of aortic or pulmonic valves leads to

Answer 15

ventricular hypertrophy

Question 16

What happens if you have total pulmonic or aortic atresia

Answer 16

you’re dead

Question 17

What is required to bypass the outflow obstruction of aortic or pulmonic atresia

Answer 17

PDA

Question 18

Atresia is associated with

Answer 18

hypoplastic right ventricle and atrial septal defect

Question 19

What does Tricuspid stenosis or atresia require for survival

Answer 19

both an ASD and PDA

Question 20

What does aortic atresia require for survival

Answer 20

both an ASD and PDA

Question 21

Four components of Tetralogy of Fallot

Answer 21

VSD, overriding aorta, pulmonic stenosis/atresia, right ventricular hypertrophy

Question 22

Transposition of the great arteries is associated with

Answer 22

diabetic mothers

Question 23

What do you need with transposition of the great arteries to survive

Answer 23

ASD and VSD or PDA

Question 24

Coarctation of the aorta occurs more often in which people

Answer 24

males more often

associated with Turner’s syndrome

Question 25

What are the two forms of coarctation of the aorta

Answer 25

infantile and adult form

Question 26

Describe the infantile form of coarctation of the aorta

Answer 26

appears early in life; narrowing is proximal to ductus arteriosus; leads to RVH in utero and cyanosis at birth

Question 27

Describe the adult form of coarctation of the aorta

Answer 27

narrowing distal to ductus arteriosus; HTN of the upper extremities; arterial insufficiency in lower extremities; collateral circulation; CHF/intracranial hemorrhage

Question 28

Cor pulmonale results from

Answer 28

pulmonary HTN secondary to lung disease

Question 29

Describe fetal circulation

Answer 29

one umbilical vein carrying oxygenated blood and 2 umbilical arteries returning deoxygenated blood; flow in heart right to left; PDA allows some blood flow to lungs