Congenital Heart Defects

Question 1

What do you need to know about PDA

Answer 1

Patent Ductus Arteriosus

Constant machine like murmur on the upper left sternal border

Symptoms: dyspnea and possible CHF

Close with indomethacin or surgery

Keep open with Prostaglandin E2

Associated with rubella and high altitude

Question 2

What do you need to know about VSD

Answer 2

Ventral septal defect
Most common congenital heart defect

Holosystolic murmur next to the sternum

Usually resolves on its own

Watch for Fetal Alcohol, TORCH, and Down syndrome

Question 3

What do you need to know about ASD

Answer 3

Atrial Septal Defect
Often persist into adulthood

Fixed S2 and palpitations

Most do not require repair unless very large

Question 4

What do you need to know about Tetralogy of Fallot

Answer 4

Most common Cyanotic heart defect

Four defects:
VSD
RVH 
Pulmonary Artery Stenosis
Overriding Aorta 

Look for “tet” spells (squatting after exhertion)

Question 5

What do you need to know about Coarctation of the Aorto

Answer 5

Upper extremity hypertension only

Radiofemoral delay

Systolic murmur over mid upper back

Rib notching on radiograph

Assoc with Turner syndome

Question 6

Name the noncyanotic congenital heart defects.

Answer 6

ASD
VSD
PDA

Noncyanotic heart diseases result in left-to-right shunts in which oxygenated blood from the lungs is shunted back into the pulmonary circulation, resulting in a “pink baby.” These noncyanotic heart conditions can be remembered by the three Ds: ventricular septal defect (VSD), atrial septal defect (ASD), and patent ductus arteriosus (PDA).

Question 7

Name the cyanotic congenital heart defects.

Answer 7

These cyanotic heart conditions can be remembered by the five Ts and the mnemonic 12345:
1 Truncus Arteriosus
2 Transpotion of the great vessels
3 Tricuspid Atresia
4 Tetralogy of Fallot
5 Total Anomolous Venous Pulmonary Return

Cyanotic heart disease results in a right-to-left shunt in which deoxygenated blood is shunted into the systemic circulation, resulting in a “blue baby.”