R To L Shunts

Question 1

Types of right to left shunts (5T)

Answer 1

Truncus arteriosus
Transpositions of great vessels
Tricuspic atresia
Tapvr
Tetralogy of fallot

Question 2

Persistant trancys arteriosus

Answer 2

Failure of division of aorta an pulmonary artery division

Compensation : VSD

Question 3

Transposition of great vessels

Answer 3

Compensation: VSD , PDA, patent foramen ovale

Question 4

Tricuspid atresia

Answer 4

RV hypoplasia,

Compensation: vSd , asd

Question 5

Tetralogy of fallot

Answer 5

Most common cause of early cyanosis
Anterosuperior displacement of infundibular septum
Associated with digeorge syndrome

PROV:

• pulmonary infundibular stenosis
• RVH
• overriding aorta
• VSD

Boot shaped heart on xray (RVH)
Pulmonary stenosis: R>L (tet spell) [caused by crying, fever, exercise]

Squat: SVR ⬆️, R to L shunt ⬇️, improves cyanosis

Question 6

TAPVR

Answer 6

Pulmonary vein darin into right heart

To maintain CO: ASD, PDA

Question 7

Ebstein anomaly

Answer 7

Downward displacement of tricuspid valve into RV
Associated with TR, Rt. HF, accessory conduction pathway

Caused by lithium exposure