Congenital Heart disease

Question 1

Most common malformation

Answer 1

Ventricular septal defect (VSD)

Question 2

Pan-systolic murmur

Answer 2

Ventricular septal defect (VSD)

Question 3

High pulmonary BP

Answer 3

Ventricular septal defect (VSD)

Question 4

Treatment of Ventricular septal defect

Answer 4

SMALL = close spontaneously
LARGE = surgery

Question 5

Pathophysiology of Ventricular septal defect

Answer 5

LV pressure > RV pressure causing a L to R shunt which increases pulmonary pressure

Question 6

What is associated with Einsenmenger’s complex ?

Answer 6

Ventricular septal defect

Question 7

What is Einsenmenger’s complex?

Answer 7

Pulmonary pressure gets so high that a R to L shunt occurs

Question 8

Ventricular septal defect increases future risk of what?

Answer 8

Infective endocarditis

Aortic regurgitation

Question 9

Pathophysiology of Atrial septal defect

Answer 9

LV pressure > RV pressure causing a L to R shunt which increases pulmonary pressure

Question 10

Location of sinus venous defect (type of ASD)

Answer 10

near SVC OR near IVC

Question 11

Location of ostium scandium defect (type of ASD)

Answer 11

mid septum, fossa ovalis

Question 12

Location of premium defect (type of ASD)

Answer 12

lower part of atrial septum

Question 13

“machine gun” murmur

Answer 13

Patent ductus arterious

Question 14

Bounding pulse

Answer 14

Patent ductus arterious

Question 15

Pathophysiology of Patent ductus arterious

Answer 15

persistent communication between the pulmonary artery and the descending aorta causing a L to R shunt

Question 16

Treatment of Patent ductus arterious

Answer 16

Immature = indomethacin
>5yrs = surgery

Question 17

What defect is associated with Turner’s syndrome (1X chromosome)

Answer 17

Coarctation of the aorta

Question 18

bicuspid aortic valve

Answer 18

Coarctation of the aorta

Question 19

diminished/absent peripheral pulses

Answer 19

Coarctation of the aorta

Question 20

Rib-notching

Answer 20

Coarctation of the aorta

Question 21

Pathophysiology of Coarctation of the aorta

Answer 21

Narrowing of aorta at, or just distal to the insertion of the ductus arterious causing severe obstruction of blood flow in the descending aorta

Question 22

Treatment of Coarctation of the aorta

Answer 22

surgery

Question 23

When would Coarctation of the aorta require treatment?

Answer 23

If pressure gradient >30mmHg

Question 24

Cyanosis

Answer 24

Tetralogy of Fallot

Transposition of the great vessels

Question 25

Squatting

Answer 25

Tetralogy of Fallot

Question 26

Pathophysiology of Tetralogy of Fallot

Answer 26

This involves VSD + overriding aorta + RV outflow obstruction + RV hypertrophy, causing increased R pressure leading to a R to L shunt

Question 27

Treatment of Tetralogy of Fallot

Answer 27

surgery ASAP

Question 28

Incompatible with life

Answer 28

Transposition of the great vessels

Tetralogy of Fallot (unless surgery is undertaken immediately)

Question 29

Pathophysiology of Transposition of the great vessels

Answer 29

RV gives rise to the aorta and the LV gives rise to the pulmonary artery

Question 30

Symptom of R to L shunt

Answer 30

cyanosis