48 Questions
Which type of atrial septal defect is the most common?
Ostium secundum defect
What is the major consequence of all types of atrial septal defects?
Pulmonary hypertension
Which area is affected by ostium primum defect?
In the area inferior to the fossa ovalis
What can follow the development of pulmonary hypertension in atrial septal defects?
Shunt reversal and cyanosis
What is the reason for lower resistance to blood flow across the atrial septal defect with left-to-right shunt?
Lower resistance in the right heart and lungs than in the systemic circulation
When does pulmonary hypertension usually develop in patients with atrial septal defects?
After the patient’s third decade
Which imaging technique is most valuable for delineating the shunt in patients with a larger ductal defect?
Echocardiography
What is a significant complication associated with Coarctation of the Aorta in patients in the second and third decades?
Cerebral arterial rupture
What is a common manifestation of Coarctation of the Aorta in older children?
Mild fatigue
In which patients is prophylaxis against infective endocarditis appropriate?
All cases of Coarctation of the Aorta
What is the most likely finding on ECG for patients with Coarctation of the Aorta?
Left ventricular hypertrophy
What kind of defect characterizes Tetralogy of Fallot?
A large ventricular septal defect
What is a common radiological finding associated with Coarctation of the Aorta?
Figure-three configuration of the left aortic margin
Which diagnostic test demonstrates LA and LV hypertension and a significant systolic pressure across the coarctation?
Cardiac Catheterization
What is present in approximately half of patients with Coarctation of the Aorta?
Bicuspid aortic valve
What is indicated in cases where patients do not respond dramatically to decongestive measures for Coarctation of the Aorta?
Surgical treatment
What is an important feature of Tetralogy of Fallot's pathology?
Malformed and stenotic pulmonary valve
Which test offers diagnostic confirmation through Doppler flow pattern and gradient estimates for Coarctation of the Aorta?
Echocardiography
What is the typical age at which most cases of tetralogy of Fallot are recognized due to cyanosis?
In the first few months of life
Which symptom is common in individuals with tetralogy of Fallot?
Hyperpnea
What is the term used for attacks of suddenly increasing cyanosis and hyperpnea that occur in infants and young children with tetralogy of Fallot?
Hypoxic spells
In individuals with tetralogy of Fallot, what is seen in those with cyanosis of more than 3 months’ duration?
Clubbing
What type of murmur is usually audible at the left midsternal border in individuals with tetralogy of Fallot?
Systolic ejection murmur
What is characteristic in the chest X-ray of individuals with tetralogy of Fallot during childhood?
"Coeur en sabot"
Which condition is confirmed by the presence of a large ventricular septal defect with right-to-left shunting and delineation of the severity and location of the right ventricular outflow tract obstruction?
Tetralogy of Fallot
Which structural components can be demonstrated using echocardiography in tetralogy of Fallot?
All structural components including the level of RV outflow tract obstruction
What should be frequently evaluated to avoid the development of severe polycythemia or relative anemia in individuals with tetralogy of Fallot?
Hemoglobin and hematocrit levels
What is common in individuals with tetralogy of Fallot due to complications of cyanosis and polycythemia?
Brain abscess and stroke
What position is used for treating hypoxic spells in individuals with tetralogy of Fallot?
Knee-chest position
What intervention is indicated at any age for patients with progressive symptoms?
Prompt surgical intervention
Which murmur is most likely to be heard in patients with ostium primum defects?
Midsystolic crescendodecrescendo murmur at the left upper sternal border due to increased right ventricular stroke volume
Which diagnostic test may identify patients with increased pulmonary arterial resistance and shunt reversal in atrial septal defect (ASD)?
Pulse oximetry at rest and with exercise
What is considered the standard of care to guide closure of interatrial communications?
TEE-TRANSESOPHAGEAL ECHOCARDIOGRAPHY
What is characteristic of the electrocardiogram in atrial septal defect (ASD)?
rsR’ pattern in the right precordial leads
What is recommended for closure just prior to school age for patients with a significant shunt with a flow ratio Qp/Qs of 1.5:1?
Surgery or interventional closure
What type of VSD is classified as the most common type?
Paramembranous defects
Which functional alteration depends on the size of the ventricular septal defect (VSD)?
Left-to-right shunt
Which of the following is a common complication associated with atrial septal defect (ASD)?
Infective endocarditis
What may be necessary to determine detailed hemodynamics in patients with atrial septal defect (ASD)?
Cardiac Catheterization
What may be necessary if pulmonary hypertension is present in patients with atrial septal defect (ASD)?
Surgery or interventional closure
Which of the following is a clinical manifestation of VSD?
Step up in oxygen saturation at the RV level
What is a common clinical manifestation associated with PDA?
Cyanosis involving the left arm and hand and the lower segment of the body
What is the typical finding in infants with VSD?
Continuous or machinery murmur at the left upper sternal border
What is a common physical examination finding in infants with PDA?
Loud, harsh holosystolic murmur at the lower left sternal border
What diagnostic test permits visualization of most VSD defects of significant size?
Echocardiography
What is a potential complication associated with large VSD defects?
Progressive aortic regurgitation
What is a significant volume overload on the right side of the heart associated with?
Small VSDs
What condition may result from large VSD defects?
Pulmonary vascular disease
Learn about the clinical manifestations and history associated with right-to-left shunt, including cyanosis, dyspnea, and hypoxic spells. Understand the signs and symptoms of this condition.
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