Cardiology

Question 1

What is the cause of atrial septal defect?

Answer 1

When foramen ovale doesn’t close

Question 2

What is the pathology of ASD?

Answer 2

Blood moves from the left to right atrium since pressure is higher on the left

Question 3

What are the signs of an ASD?

Answer 3

Mid-systolic crescendo-decrescendo murmur
Best heard on the upper left sternal border
Fixed split of the second heat sound

Question 4

How is ASD investigated?

Answer 4

ECHO

Question 5

How is ASD treated?

Answer 5

Small - watch and wait

Big - transvenous catheter closure

Question 6

What are the complications of ASD?

Answer 6

Stroke
AF
Pulmonary hypertension
Right sided heart failure
Eisenmenger syndrome

Question 7

What are the associations with ASD?

Answer 7

Down syndrome

Turner syndrome

Question 8

What is the cause of ventricular septal defects?

Answer 8

The ventricular septum doesn’t form properly

Question 9

What is the pathology of VSD?

Answer 9

Blood flows from the left to the right

Right sided overload, right sided heart failure, pulmonary hypertension

Question 10

What are the signs of VSD?

Answer 10

Pan-systolic murmur
Best heard over the lower left sternal border in the 3rd/4th intercostal space
Systolic thrill

Question 11

How is VSD investigated?

Answer 11

ECHO

Question 12

What is associated with VSD?

Answer 12

Down syndrome

Turner syndrome

Question 13

What is the pathology of patent ductus arteriosus?

Answer 13

It doesn’t close

Question 14

What are the signs of patent ductus arteriosus?

Answer 14

Small may be symptomatic
Normal first heart sound with a continuous crescendo-decrescendo ‘machinery’ murmur that makes the second heart sound difficult to hear

Question 15

What investigation would be done if patent ductus arteriosus was suspected?

Answer 15

ECHO

Question 16

How is patent ductus arteriosus treated?

Answer 16

Normally close on their own

Question 17

What are the 4 co-existing pathologies in tetralogy of fallot?

Answer 17

Ventricular septal defect
Overriding aorta
Pulmonary valve stenosis
Right ventricular hypertrophy

Question 18

What is tetralogy of fallot associated with?

Answer 18

DiGeorge syndrome

Question 19

What are the risk factors for tetralogy of fallot?

Answer 19

Rubella
Increased age of the mother
Alcohol consumption
Diabetic mother

Question 20

What is the pathology of tetralogy of fallot?

Answer 20

Blood flowing between ventricles
Aortic valve placed further to the right (closer to VSD) so deoxygenated blood goes to the body
Pulmonary valve stenosis pushed more deoxygenated blood through the VSD and therefore to the body

Question 21

What are the signs of tetralogy of fallot?

Answer 21

Ejection systolic murmur (pulmonary stenosis)
Heard loudest at the pulmonary area
Cyanosis

Question 22

How is tetralogy of fallot treated?

Answer 22

Total surgical repair by open heart surgery

Question 23

What is the pathology of coarctation of the aorta?

Answer 23

Narrowing of the aortic arch

Question 24

What are the signs of coarctation of the aorta?

Answer 24

Weak femoral pulses

systolic murmur - heard below the left clavicle (left infraclavicular)

Question 25

What investigation would be done if coarctation of the aorta was suspected?

Answer 25

4 limb BP - high blood pressure in the limbs before the narrowing, low in the rest ECHO

Question 26

How is coarctation of the aorta treated?

Answer 26

Depends on severity | Leave it or surgery

Question 27

What is associated with coarctation of the aorta?

Answer 27

Turner syndrome

Question 28

What is the pathology of transposition of the great vessels?

Answer 28

Right ventricle pumps blood into the aorta | Left ventricle pumps blood into the pulmonary vessels

Question 29

What are the signs of transposition of the great vessels?

Answer 29

Life threatening after birth as no connection between systemic and pulmonary circulation Cyanosed

Question 30

How is transposition of the great vessels treated?

Answer 30

Need to form a shunt to wait for surgery If VSD this is a shunt If not, give prostaglandins to maintain ductus arteriosus

Question 31

What are the 8 common lesions?

Answer 31

``` Ventricular septal defect Patent ductus arteriosus Atrial septal defect Pulmonary stenosis Aortic stenosis Coarctation of the aorta Transposition of the great arteries Tetralogy of fallot ```

Question 32

What are the causes of congenital heart disease?

Answer 32

Genetic susceptibility Environmental hazard Teratogenic insult - 18-60 days post contraception Environmental factors - drugs, infections, maternal (DM, SLE)

Question 33

What are the features of innocent murmurs?

Answer 33

``` S's: Short Soft Systolic Symptomless ```