Acyanotic Congenital Cardiac Diseases

Question 1

Ventricular Septal Defect Cx Fx

Answer 1

Dyspnea with respiratory distress
High-pitched holosystolic murmur over lower left sternal border
Loud pulmonic S2

Question 2

Ventricular Septal Defect Dx

Answer 2

Chest x-ray shows increased vascular markings.

Echocardiogram is diagnostic and cardiac catheterization is definitive.

Question 3

Ventricular Septal Defect Tx

Answer 3

Smaller lesions usually close in 1 to 2 years

Larger or more
symptomatic lesions: surgical intervention.

Diuretics and digoxin can be used for more conservative treatment.

Question 4

Atrial Septal Defect Cx Ft

Answer 4

usually asymptomatic except for a fixed wide splitting of S2.

Question 5

Atrial Septal Defect Dx

Answer 5

most definitive test is cardiac catheterization. However, echocardiography is
less invasive and can be just as effective

(CXR): increased vascular markings and cardiomegaly.

Question 6

Atrial Septal Defect Tx

Answer 6

• Vast majority close spontaneously
• Surgery or transcatheter closure is indicated for all symptomatic patients
• Dysrhythmias and possible paradoxical emboli from DVTs later in life

Question 7

Patent Ductus Arteriosus (PDA) Cx Fx, physical examination reveals:

Answer 7

is a normal finding in the first 12 hours of life. After 24 hours it is considered pathologic.

• “Machinery-like” murmur
• Wide pulse pressure
• Bounding pulses

Question 8

Patent Ductus Arteriosus (PDA) complications

Answer 8

high occurrence of respiratory infections and infective endocarditis is the most common complication later in the child’s life.

Question 9

Patent Ductus Arteriosus (PDA) Dx

Answer 9

Echocardiography is the best initial test, while cardiac catheterization is the
most accurate test.

EKG may show LVH secondary to high systemic resistance.

Question 10

Patent Ductus Arteriosus (PDA) Tx

Answer 10

Give indomethacin (NSAID inhibits prostaglandins) to close the PDA unless it is
needed to live in concurrent conditions such as TOF

Question 11

what pathologies correspond the following Xr findings

Pear-shaped:
Boot-shaped heart:
Jug handle appearance:
“3”-like appearance or rib notching:

Answer 11

Pear-shaped: pericardial effusion
Boot-shaped heart: tetralogy of Fallot
Jug handle appearance: primary pulmonary artery hypertension
“3”-like appearance or rib notching: coarctation of the aorta

Question 12

Coarctation of the Aorta, asociated disease

Answer 12

Turner syndrome=
short girl with webbed neck, shield
chest, streak gonads, horseshoe
kidneys, or shortened fourth
metacarpal,

Question 13

Coarctation of the Aorta Dx

Answer 13

Rib notching and a “3” sign are seen on chest x-ray.

Cardiac catheterization is the most accurate test

Question 14

Coarctation of the Aorta Tx

Answer 14

surgical resection of the narrowed segment and then balloon

dilation if recurrent stenosis occurs