Congenital Heart Disease

Question 1

Structural abnormalities present at birth

Answer 1

congenital heart disease

Question 2

4 reasons for congenital heart disease

Answer 2

Chromosomal abnormalities
Environmental associations
Rubella
Genetic predisposition

Question 3

Turner syndrome (XO) is associated with

Answer 3

coarctation of the aorta

Question 4

Down syndrome (trisomy 21) is associated with

Answer 4

Atrial and ventricular septal defects
Atrioventricular valve deformities

Question 5

There is an increase in __ in pregnancy at high altitudes

Answer 5

Patent ductus arteriosus

Question 6

Rubella (german measles) is a prominent cause of CHD. Congenital rubella syndrome causes

Answer 6

cardiovascular malformations
Microcephaly

Question 7

Common cardiac malformations associated with congenital rubella syndrome

Answer 7

Pulmonary artery stenosis
Patent ductus arteriosus

Question 8

This is a genetic predisposition

Answer 8

Tetralogy of fallot

Question 9

CHD can be classified according to the presence or absence of

Answer 9

cyanosis

Question 10

Non-cyanotic CHD

Answer 10

left to right shunt ( patent ductus arteriosis or atrial or ventricular septal defect)

Question 11

This can cause obstructive lesion like coarctation of the aorta and aortic stenosis

Answer 11

Non-cyanotic CHD

Question 12

Transposition of the great vessels, malformations with a right to left shunt (tetralogy of fallot), left to right shunt reverses flow to right to left because of increased pulmonary pressure

Answer 12

Cyanotic CHD

Question 13

A hole from a septum secundum or septum primum defect

Answer 13

Atrial septal defect (ASD)

Question 14

Atrial septal defect produces a __

Answer 14

left to right non-cyanotic shunt

Question 15

2nd most common CHD

Answer 15

Atrial septal defect

Question 16

Smooth walled defects near the foramen ovale, NO other cardiac abnormalities

Answer 16

Ostium secundum ASD’s (75% of ASDs)

Question 17

At lowest part of atrial septum, associated with mitral and tricuspid valve abnormalities

Answer 17

Ostium primum ASDs (15-20% of ASDs)

Question 18

Upper part of atrial septum near superior vena cava, accompanied by anomalous drainage of the pulmonary veins into right atrium or superior vena cava

Answer 18

Sinus venosis (5-10% of ASDs)

Question 19

Small ASDs can __ while large ASDs can __

Answer 19

close at birth ( or be asymptomatic throughout lifetime)
cause heart failure

Question 20

Unresolved large ASDs are delayed until __ and can lead to __

Answer 20

4th decade of life
Right heart failure

Question 21

Increased incidence of atrial arrhythmias (atrial fibrillation), can lead or paradoxical embolism

Answer 21

Atrial septal defect ASD

Question 22

A flaplike opening between atria septa primum and secumdum at the location of the fossa ovalis that persists after age 1

Answer 22

Patent foramen ovale (PFO)

Question 23

Little clinical significance except when it leads to paradoxical embolism or cryptogenic strokes <55 years of age

Answer 23

Patent foramen ovale (PFO)

Question 24

Normally the __ keeps the PFO closed but transient __ can occur such as with valsalva-type manuvers

Answer 24

left atrial pressure
R to L blood flow

Question 25

A hole within the intraventricular septum that produces a left to right non-cyanotic shunt

Answer 25

Ventricular septal defect (VSD)

Question 26

This is the most common CHD!

Answer 26

Ventricular septal defect (VSD)

Question 27

Larger ventricular septal defects can cause __

Answer 27

tachypnea, tachycardia and heart failure

Question 28

In adults with untreated VSD __ is common

Answer 28

Left sided heart failure

Question 29

With __ the shunt will reverse flow to right to left in VSD

Answer 29

pulmonary hypertension

Question 30

Failure of closure of the fetal ductus arteriosis

Answer 30

Patent ductus arteriosus (PDA)

Question 31

Patent ductus arteriosus produces a __

Answer 31

Left to Right non-cyanotic shunt

Question 32

3rd most common CHD

Answer 32

Patent ductus arteriosis (PDA)

Question 33

Can be due to premature/low birth weight, low oxygen tension, 1st trimester maternal rubella

Answer 33

patent ductus arteriosis (PDA)

Question 34

Narrowing or constriction of the aorta - occurs near the ligamentum arteriosim just distal to the origin of the left subclavian artery

Answer 34

Coarctation of the aorta

Question 35

Coarctation of the aorta can lead to

Answer 35

left ventricular outflow obstruction

Question 36

The narrowing that occurs with coarctation of the aorta can be __ or __ in relation to ductus arteriosus

Answer 36

preductal (infantile) Postductal (adult)

Question 37

This is usually present in preductal coarctation the the aorta

Answer 37

patent ductus arteriosus

Question 38

Symptomatic early in life, classically as cyanosis localized to the lower half of the body (without treatment infants die in neonatal)

Answer 38

Preductal coarctation of the aorta (with PDA)

Question 39

Usually asymptomatic, sometimes well into adult life, when symptoms develop, hypertension is limited to the upper extremities and cerebral vessels with low blood pressure in the lower extremities

Answer 39

Postductal coarctation of the aorta (WITHOUT PDA)

Question 40

The most common form of cyanotic (right to left) CHD

Answer 40

Tetralogy of fallot (TOF)

Question 41

4 major features of tetralogy of fallot

Answer 41

Obstruction of the right ventricular outflow tract Concentric right ventricular hypertrophy Ventricular septal defect (VSD) Dextroposition of the aorta

Question 42

Obstruction of the right ventricular outflow tract can be due to what 3 things

Answer 42

subpulmoic stenosis pulmonary calce stenosis complete atresia

Question 43

What is the definitive treatment for TOF

Answer 43

Complete surgical repair

Question 44

Decreased pulmonary blood flow and increased aortic volumes are present at birth with

Answer 44

Tetralogy of fallot (TOF)

Question 45

The second most common form of cyanotic (right to left) CHD

Answer 45

Transposition of the great arteries (TGA)

Question 46

In transposition of the great arteries, the aorta arises from the __ and the pulmonary artery emanates from the __

Answer 46

right ventricle Left ventricle

Question 47

What is needed for survival of a patient with transposition of the great arteries

Answer 47

a concurrent compensatory anomaly (VSD) (ASD) (PDA)