Cs2 - Congenital Heart Disease

Front 1

Infant shows decreased O2 saturation in lower extremities, but normal pulse strength. What congenital deformity do you suspect?

Back 1

Coarctation of the Aorta (narrowing)

This patient compromised by keeping the ductus arteriosus open, which will result in deoxygenated blood from the pulmonary artery crossing over and entering the systemic circulation

Front 2

Infant shows decreased O2 saturation in lower extremities, but normal pulse strength. If this condition lasts for a long time, what physical findings would you expect to find in an adolescent?

Back 2

(Q is talking about coarctation of the aorta - narrowing of aorta )

Long term can cause left ventricular hypertrophy (pushing against increased pressure), and notching of the ribs due to enlarged collaterols

Front 3

Infant shows decreased O2 saturation in lower extremities, but normal pulse strength. If untreated, what is the average age for survival?

Back 3

20-40 (coarctation of the aorta)

If treated early, there are great outcomes. Late intervention results in premature CV disease

Front 4

Infant shows decreased O2 saturation in lower extremities, but normal pulse strength. What treatment options are there?

Back 4

(Coarctation of the aorta)

Immediate Prostaglandin E1 (alprostadil) to keep the ductus arteriosus open.

Surgical repair

Front 5

Upon P/E of a 2 yo you note a sharp pulmonic ejection click, split S2 and a low pitched systolic ejection murmur. What congenital abnormality do you suspect?

Back 5

Pulmonic valve stenosis


These pts are usually asymptomatic unless severe. Pts can live a relatively normal life

Front 6

Upon P/E of a 2 yo you note a sharp pulmonic ejection click, split S2 and a low pitched systolic ejection murmur. If an EKG is performed, what would you expect to see?

Back 6

Tall, spiked P waves (due to right ventricular hypertrophy)

- Pulmonic Valve Stenosis

Front 7

A _ is often not discovered until autopsy

Back 7

Atrial Septal Defect

Front 8

Auscultation of an adult reveals wide, fixed split S2, sometimes a murmur, can be silent if very large, low pitched mid diastolic rumble. What are these signs indicative of?

Back 8

Atrial Septal Defect

These are usually asymptomatic, and only treated if Qp:Qs is 2:1, or if pt is symptomatic

Front 9

_ accounts for 25% of CHD

Back 9

Ventricular Septal Defect

Front 10

In a Ventricular Septal Defect, what happens?

Back 10

There is a shunt between ventricles. This pushes blood from the high pressure Left ventricle into the lower pressure right ventricle. More blood gets pushed into the lungs, leading to pulmonary hypertension.

If Rpulm:Rsys =1, the shunt can reverse, and pt will be cyanotic

Front 11

If a Ventricular Septal Defect is small, the patient will be _, but may have a _ upon auscultation

Back 11

asymptomatic

harsh, blowing holosystolic murmur

Front 12

If a Ventricular Septal Defect is large, what can it cause?

Back 12

Dyspnea, feeding difficulties, poor growth, heart failure.

Front 13

3 week old female is brought in by her mother because of feeding difficulties. You notice that when the baby cries, she gets a slight dusky color. What do you expect to hear upon auscultation?

Back 13

Harsh, blowing holosytolic murmur.

This is a more severe ventricular septal defect.

The baby turns "dusky" when crying because pulmonary resistance increases, reversing the shunt and causing unoxygenated blood to enter the left ventricle and go into the systemic circulation)

Front 14

3 week old female is brought in by her mother because of feeding difficulties. You notice that when the baby cries, she gets a slight dusky color. Auscultation reveals a blowing holosystolic murmur. What would you expect to see on an EKG?

Back 14

Peaked or notched P waves due to biventricular hypertrophy


(Ventricular septal defect)

Front 15

A continuous machinery like murmur is indicative of what type of congenital heart defect?

Back 15

Patent Ductus arteriosus

If small, the pt will be asymptomatic, if large it could result in growth retardation

Front 16

What is wrong in Ebstein Anomaly?

Back 16

An abnormal muscle of the right ventricle causes an insuffiecient tricuspid valve which drops down into the ventricle, resulting in leakage and blockage of the outflow

Front 17

What is the clinical presentation of ebstein anomaly?

Back 17

cyanosis, holosystolic murmur, gallop, cardiomegaly

Front 18

What part of embryological development goes wrong in transposition of great arteries?

Back 18

rotation. There are connections with wrong parts of the heart.

Front 19

Newborn boy is severely cyanotic, tachypneic. CXR shows an egg shaped heart, and EKG reveals right dominance. What do you give him initially before he can be rushed into surgery?

Back 19

PGE1 to keep ductus arteriosus

This newborn has transposition of the great arteries

Front 20

What are the 5 T's of cyanotic congenital heart disease?

Back 20

Tetralogy of Fallot, Transposition of great arteries, truncus arteriosus, tricuspid atresia, total anomalous pulmonary venous return, tiny left heart (hypoplastic)

Front 21

What are the main problems of tetralogy of fallot (4)

Back 21

Stenosis of pulmonary valve,

ventricular septal defect,

aorta overrides the ventricular septum,

R ventricular hypertrophy