Congenital cardiac abnormalities

Question 1

What are the 3 types of VSD?

Answer 1

Subaortic
Perimembranous
Muscular

Question 2

What is VSD associated with?

Answer 2

Down’s

Turner’s

Question 3

What is the presentation of VSD?

Answer 3

Pansystolic murmur- harsh 
Dyspnoea, tachypnoea
Poor feeding, failure to thrive
Shunt= right heart failure, pulmonary hypertension
Severe= signs of heart failure

Question 4

What is the management of VSD?

Answer 4

Closure- trans catheter or surgical

Question 5

What is a complication of VSD?

Answer 5

Eisenmengers syndrome= pressure in R heart greater than L –> reversal of shunt and cyanosis

Question 6

What is the presentation of ASD?

Answer 6

Less severe than VSD
Generally well in early childhood and good chance of spontaneous closure
Poor feeding, failure to thrive, dyspnoea
Shunt= right heart failure, pulmonary hypertension

Question 7

What is the management of ASD?

Answer 7

Closure- trans catheter or surgical

Question 8

What are complications of ASD?

Answer 8

AF
Heart failure
Pulmonary hypertension
Eisenmenger’s

Question 9

What is AVSD?

Answer 9

Atrio-ventricular septal defect

Single AV valve with ASD and high VSD

Question 10

What is AVSD associated with?

Answer 10

Down’s

Question 11

What is PDA?

Answer 11

Patent ductus arteriosus

Connection between pulmonary trunk and descending aorta that fails to close

Question 12

Who is PDA common in?

Answer 12

Preterm babies

Question 13

Wat is the presentation of PDA?

Answer 13

Dyspnoea
Left subclavicular thrill
Continuous murmur
Large volume, bounding collapsing pulse

Question 14

What is the management of PDA?

Answer 14

1. Indomethacin

2. Closure with umbrella device

Question 15

What is coarctation of the aorta?

Answer 15

Congenital narrowing of descending aorta

Question 16

What is coarctation of the aorta associated with?

Answer 16

Turner’s

M>F

Question 17

What is the presentation of coarctation of the aorta?

Answer 17

Heart failure 
Radio-femoral delay
Weak femoral pulses 
Hypertension in arms, hypotension in legs 
Midsystolic murmur

Question 18

What is the management of mild coarctation of the aorta?

Answer 18

Watch and wait

Question 19

What is the management of severe coarctation of aorta?

Answer 19

Surgery

Use prostaglandin E until surgery to keep PDA open

Question 20

What is the tetralogy of Fallot?

Answer 20

VSD
Overriding aorta
Pulmonary stenosis
RV hypertrophy

Question 21

What are the risk factors for tetralogy of Fallot?

Answer 21

Maternal rubella

Question 22

What is tetralogy of Fallot associated with?

Answer 22

Down’s

Question 23

What is the presentation of tetralogy of Fallot?

Answer 23

Ejection systolic urmur
Heart failure before 1yo
Cyanosis
Tet spells on exertion- turn blue, difficulty breathing

Question 24

What investigations are done for tetralogy of Fallot?

Answer 24

Echo
Doppler
CXR

Question 25

What is seen on CXR in tetralogy of Fallot?

Answer 25

Boot shaped heart

Question 26

What is the management of tetralogy of Fallot?

Answer 26

Open heart surgery and total surgical repair

Question 27

What is transposition of the great arteries TGA?

Answer 27

Aorta connection to RV and pulmonary trunk to LV

Question 28

What is the patient dependent on to live in TGA?

Answer 28

Shunt between 2 circulations- ASD, VSD, PDA

Question 29

What is the presentation of TGA?

Answer 29

Cyanosis Tachycardia Failure to thrive Normally diagnosed prenatally

Question 30

What is the management of TGA?

Answer 30

Arterial switch procedure

Question 31

What is congenital aortic stenosis associated with?

Answer 31

William's

Question 32

What is the presentation of aortic stenosis?

Answer 32

Usually asymptomatic unless severe Ejection systolic murmur, radiation to carotids Slow rising pulse, narrow pulse pressure Severe= exertion chest pain, syncope, reduced exercise tolerance

Question 33

What investigations are done for artic stenosis?

Answer 33

Echo ECG Exercise tolerance test

Question 34

What is th management of congenital aortic stenosis?

Answer 34

Percut balloon valvuloplasty Surgical valvotomy Valve replacement

Question 35

What is congenital pulmonary stenosis associated with?

Answer 35

Noonan | Tetralogy of Fallot- rubella and Down's

Question 36

What is the presentation of pulmonary stenosis?

Answer 36

``` Mild= asymptomatic Severe= exertion dyspnoea, fatigue, RV heave and hypertrophy , raised JVP ```

Question 37

What investigation is done for pulmonary stenosis?

Answer 37

Echo

Question 38

What is the management of congenital pulmonary stenosis?

Answer 38

Mild= watch and wait 1. Balloon valvuloplasty 2. Open heart surgery

Question 39

What is Ebstein's anomaly?

Answer 39

Low insertion of tricuspid --> large RA and small RV

Question 40

What is Ebstein's anomaly associated with?

Answer 40

WPW | Lithium in utero

Question 41

What cardiac anomalies is Down's associated with?

Answer 41

AVSD most common VSD Tetralogy of Fallot

Question 42

What cardiac anomalies is Turner associated with?

Answer 42

VSD | Coarctation of aorta