defect

Question 1

most common congenital heart defect

Answer 1

ventricular septal defect

Question 2

congenital VSDs are often association with chromosomal disorders
Down's syndrome
Edward's syndrome
Patau syndrome
cri-du-chat syndrome

but also acquired such as

Answer 2

post MI - 3-14 days

Question 3

when may a VSD be detected

Answer 3

during routine 20 week scan in utero
post fatally also include failure to thrive, features of HF such as hepatomegaly, tacky c and p and pallor

pan systolic murmur louder in smaller defects

Question 4

management of VSD

Answer 4

small close on own with monitoring

moderate to large need nutritional support, medication for HF such as diruretics and surgical closure

Question 5

complications of VSD

Answer 5

aortic regurgitation
aortic regurgitation is due to a poorly supported right coronary cusp resulting in cusp prolapse
infective endocarditis
Eisenmenger’s complex
due to prolonged pulmonary hypertension from the left-to-right shunt
results in right ventricular hypertrophy and increased right ventricular pressure. This eventually exceeds the left centricular pressure resulting in reversal of blood flow
this is turn results in cyanosis and clubbing
Eisenmenger’s complex is an indication for a heart-lung transplant
right heart failure
pulmonary hypertension
pregnancy is contraindicated in women with pulmonary hypertension as it carries a 30-50% risk of mortality

Question 6

HF affects what part of stroke volume

Answer 6

preload