Congenital Heart Defects

Question 1

Name three congenital heart defects that present with heart-failure?

Answer 1

Ventricular septal defect (most common)
Atrioventricular septal defect
Patent ductus arteriosis

Question 2

Name two congenital heart defects that present with a murmur?

Answer 2

Pulmonary valve stenosis

Atrial septal defect

Question 3

Name two congenital heart defects that present with shock?

Answer 3

Co-arctation of the aorta

Aortic stenosis

Question 4

Name two congenital abnormalities that present with cyanosis?

Answer 4

Tetralogy of Fallot

Transposition of the great vessels

Question 5

Describe three clinical findings in a child with VSD?

Answer 5

SOB particularly of feeding
Harsh pan-systolic murmur radiating all over chest
Cardiomegaly with displaced apex beat

Question 6

If left untreated VSD can lead to Eisenmenger’s syndrome - what is this?

Answer 6

Shunting = Increased pulmonary blood flow = Pulmonary hypertension and hypertrophy = eventually intractable cyanosis of the peripheries

Question 7

Which congenital heart defect is associated with Down’s syndrome?

Answer 7

Atrioventricular defect (40%)

Question 8

Describe two clinical findings with a patent ductus arteriosis and name the major risk factor for its occurrence?

Answer 8

Continuous machinery murmur (below L clavicle)
Collapsing pulse
R/F = Prematurity

Question 9

Describe three clinical findings with pulmonary valve stenosis?

Answer 9

Cyanosed at birth
Ejection systolic murmur - radiates to back
Severe stenosis = palpable thrill

Question 10

Name and describe the two forms of atrial septal defect?

Answer 10

Ostium secundum = foreman ovale and atrial septum

Ostium primum - atrioventricular septum

Question 11

Describe two clinical findings associated with atrial septal defects?

Answer 11

Often asymptomatic at birth
Fixed split - 2nd heart sound (no variation with respiration)
Pulmonary flow murmur
(recurrent chest infections)

Question 12

Name 5 clinical findings with co-arctation of the aorta?

Answer 12

Acidosis
Weak/absent femoral pulse
BP greater in arms than legs
O2 sats greater in hands than legs
If mild = Increased BP in young adults

Question 13

Name the triad associated with aortic stenosis and describe the murmur?

Answer 13

SOB on exertion 
Chest pain
Syncope
Ejection systolic - radiates to neck
R/F for sudden death

Question 14

Name the four constituents of tetralogy of Fallot?

Answer 14

VSD
Pulmonary stenosis
R ventricular hypertrophy
Overiding aorta

Question 15

What is the main clinical finding of tetralogy of Fallot and name the major risk factor?

Answer 15

Cyanosis
Ejection systolic murmur
Foetal alcohol syndrome

Question 16

In transposition of the great arteries what are the two main clinical findings?

Answer 16

Cyanosis - severe (at birth)

Acidosis

Question 17

Which congenital heart defect is associated with Turner’s syndrome?

Answer 17

Co-arctation of the aorta

Question 18

Describe the ECG findings in VSD?

Answer 18

Bi-ventricular hypertrophy

Question 19

Describe the ECG findings in atrio-ventricular septal defect?

Answer 19

Superior axis

Question 20

Describe the ECG findings in pulmonary stenosis?

Answer 20

R ventricular hypertrophy

Question 21

Describe the ECG findings in aortic stenosis?

Answer 21

L ventricular hypertrophy

Question 22

Describe the ECG findings in tetralogy of Fallot?

Answer 22

R ventricular hypertrophy

‘Boot’ shaped heart on CXR