Disease States

Question 1

Eisenmenger Syndrome

Answer 1

Right-to-Left shunt in the heart whether from Atrial Septal Defect, Ventricular Septal Defect or Patent Ductus Arteriosus -> cyanosis

The ASD, VSD or PDA normally start as left-to-right shunts, but, pulmonary hypertension leads to right-to-left.

Question 2

ASD

Answer 2

Arterial Septal Defect

Question 3

VSD

Answer 3

Ventricular Septal Defect

Question 4

PDA

Answer 4

Patent Ductus Arteriosus

Question 5

Coarctation of the Aorta

Answer 5

Narrowing of the aortic lumen somewhere near the local of the ductus arteriosus

Question 6

Aortic Stenosis

Answer 6

Murmur of blood through the aortic valve (A2 portion of S2 heart sound). Can be related to being bicuspid instead of tricuspid and/or calcification of the leaflets themselves.

Question 7

Pulmonic Stenosis

Answer 7

Murmur of blood through the pulmonic valve (P2 portion of S2 heart sound). Can be related to being bicuspid instead of tricuspid and/or calcification of the leaflets themselves.

Question 8

Claudication

Answer 8

Pain, discomfort or tiredness in the legs that occurs during walking and is relieved by rest.

Many etiologies, however, Eisenmenger Syndrome is definitely one possibility.

Question 9

Tetralogy of Fallot

Answer 9

(1) Ventricular septal defect (VSD),
(2) Obstruction to right ventricular outflow
(3) Overriding aorta that receives blood from both ventricles, and
(4) Right ventricular hypertrophy (due to 2 above)

Children often squat to kink the femoral arteries -> increased systemic vascular resistance -> decreased right to left shunt -> increased flow to lungs

Question 10

TGA

Answer 10

Transposition of the Great Arteries such that the RV feeds the aorta and the LV feeds the PA.

Is considered a medical emergency upon birth as ductus arteriosus closes eliminating the life-sustaining mixing of blood.

Question 11

Acyanotic Defects

Answer 11

Congenital heart defects that don’t lead to cyanosis though lead to other issues like fatigue, failure to thrive, digital clubbing, etc. (can lead to Eisenmenger Syndrome)
Volume Overload = ASD, VSD, PDA
Pressure Overload = AS, PS, Coarctation of the Aorta

Question 12

Cyanotic Defects

Answer 12

Congential heart defects leading to systemic cyanosis
TGA and Tetralogy of Fallot the most common (pulmonary hypertension in acyanotic defects can lead to Eisenmenger Syndrome, i.e., cyanosis)