Congenital heart disease

Question 1

What is a PFO?

Does it need treatment

Answer 1

A small persistent communication between the atria

Does not require closure

Question 2

What is an ASD?

Does it need treatment?

Answer 2

An atrial septal defect is larger, bidirectional shunt of haemodynamic significance. They load the right heart –> right ventricle dilatation and dysfunction and pulm HTN

Needs to be closed if >10mm, shunt ratio >1.5

Question 3

What is a VSD?

Does it need treatment?

Answer 3

A shunt between left and right ventricles –> loads the left ventricle

Needs intervention if haemodynamic compromise
Loud murmur = high pressure jet = small VSD = no intervention

Question 4

What is Coarctation of the aorta

Does it need treatment?

Answer 4

Narrowing of the descending thoracic aorta usually near the site of the ductus arteriosus
–> HTN in cranial and brachial vasculature with relative hypotension below the coarctation

Treat with stenting if HTN and moderate to severe gradient

Question 5

Patent Ductus Arteriosus?

Does it need treatment?

Answer 5

Persistence of the fetal circulation with shunt from the aorta to the pulmonary artery

Very high risk of endocarditis

Adults repair percutaneously to prevent endocarditis