Cardio - DDx

Question 1

Cyanotic CHD

Answer 1

• Tetralogy of Fallot
• Pulmonary Atresia
• Tricuspid Atresia
• Eisenmenger’s Syndrome
• Transposition of the Great Arteries (Dextro-TGA)
• Ebstein’s Anomaly

Question 2

Non-cyanotic CHD

Answer 2

Non-Shunting:
- Aortic Stenosis
- Pulmonary Stenosis
- (Adult/Post-ductal) Co-arctation of the Aorta
- Simple Levo-TGA

Shunting:
- ASD
- VSD
- AVSD
- PDA

Question 3

Restrictive Cardiomyopathy

Answer 3

Mnemonic: EL RICH-ASS

Primary:
- Endomyocardial Fibrosis
- Loeffler’s Endocarditis

Secondary:
- Radiation
- Iron Overload
- Cardiac Tumours
- Hydroxychloroquine
- Amyloidosis
- Sarcoidosis
- Systemic Sclerosis

Question 4

Constrictive Pericarditis

Answer 4

Mnemonic: CPI (Constrictive Pericard-Itis)

• Connective Tissue Disease
• Chronic Renal Failure
• Post-MI (Dressler’s)
• Post-procedural
• Post-irradiation
• Post-trauma/haemopericardium
• Idiopathic
• Infective (viral/bacterial)
• Infiltrative (sarcoidosis/amyloidosis)

Question 5

Fixed Split S2

(High pitched, heard best in PV area)

Answer 5

Delayed P2:
- ASD
- Pulmonary Stenosis
- RBBB
- Pulmonary Hypertension
- RHF

Paradoxical (P2 before A2)
- RV Pacemaker
- LBBB
- Aortic Stenosis
- HCM

(Transient S2 splitting on INSPIRATION is physiological:
decreased intrathoracic pressure -> increased venous return to RA -> increased RV pressure -> delayed PV closure)

Question 6

Mitral Valve Stenosis

(Rumbling, low- pitched, mid diastolic murmur, decrescendo-crescendo, heard at apex, +/- opening snap just after S2)

Answer 6

• Rheumatic Fever
• Infective Endocarditis
• Calcification
• Connective Tissue Disease
• Carcinoid
• Fabry’s Disease
• Whipple’s Disease

Question 7

Aortic Regurgitation

(Early diastolic decrescendo murmur, heard in aortic area/LLSE)

Answer 7

Acute
- Infective Endocarditis
- Aortic dissection

Chronic
- Aortopathy/aortic root dilatation (Marfan’s, Hypertension, Ank Spond, RA, Syphilis)
- Bicuspid aortic valve
- Rheumatic fever
- Iatrogenic (post-balloon valvuloplasty, prosthetic valve failure)