Clinical Manifestations of Right-to-Left Shunt

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Which type of atrial septal defect is the most common?

Atrial septal defects are equally common in all types

Ostium secundum defect (correct)

Sinus venosus defect

Ostium primum defect

What is the major consequence of all types of atrial septal defects?

Dilated left heart chambers

Pulmonary hypertension (correct)

Aortic stenosis

Systemic circulation resistance

Which area is affected by ostium primum defect?

Near the orifice of the inferior vena cava

Superior to the fossa ovalis near the orifice of the superior vena cava

In the area inferior to the fossa ovalis (correct)

In the area of the fossa ovalis

What can follow the development of pulmonary hypertension in atrial septal defects?

Shunt reversal and cyanosis Signup and view all the answers

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 Signup and view all the answers

When does pulmonary hypertension usually develop in patients with atrial septal defects?

After the patient’s third decade Signup and view all the answers

Which imaging technique is most valuable for delineating the shunt in patients with a larger ductal defect?

Echocardiography Signup and view all the answers

What is a significant complication associated with Coarctation of the Aorta in patients in the second and third decades?

Cerebral arterial rupture Signup and view all the answers

What is a common manifestation of Coarctation of the Aorta in older children?

Mild fatigue Signup and view all the answers

In which patients is prophylaxis against infective endocarditis appropriate?

All cases of Coarctation of the Aorta Signup and view all the answers

What is the most likely finding on ECG for patients with Coarctation of the Aorta?

Left ventricular hypertrophy Signup and view all the answers

What kind of defect characterizes Tetralogy of Fallot?

A large ventricular septal defect Signup and view all the answers

What is a common radiological finding associated with Coarctation of the Aorta?

Figure-three configuration of the left aortic margin Signup and view all the answers

Which diagnostic test demonstrates LA and LV hypertension and a significant systolic pressure across the coarctation?

Cardiac Catheterization Signup and view all the answers

What is present in approximately half of patients with Coarctation of the Aorta?

Bicuspid aortic valve Signup and view all the answers

What is indicated in cases where patients do not respond dramatically to decongestive measures for Coarctation of the Aorta?

Surgical treatment Signup and view all the answers

What is an important feature of Tetralogy of Fallot's pathology?

Malformed and stenotic pulmonary valve Signup and view all the answers

Which test offers diagnostic confirmation through Doppler flow pattern and gradient estimates for Coarctation of the Aorta?

Echocardiography Signup and view all the answers

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 Signup and view all the answers

Which symptom is common in individuals with tetralogy of Fallot?

Hyperpnea Signup and view all the answers

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 Signup and view all the answers

In individuals with tetralogy of Fallot, what is seen in those with cyanosis of more than 3 months’ duration?

Clubbing Signup and view all the answers

What type of murmur is usually audible at the left midsternal border in individuals with tetralogy of Fallot?

Systolic ejection murmur Signup and view all the answers

What is characteristic in the chest X-ray of individuals with tetralogy of Fallot during childhood?

"Coeur en sabot" Signup and view all the answers

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 Signup and view all the answers

Which structural components can be demonstrated using echocardiography in tetralogy of Fallot?

All structural components including the level of RV outflow tract obstruction Signup and view all the answers

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 Signup and view all the answers

What is common in individuals with tetralogy of Fallot due to complications of cyanosis and polycythemia?

Brain abscess and stroke Signup and view all the answers

What position is used for treating hypoxic spells in individuals with tetralogy of Fallot?

Knee-chest position Signup and view all the answers

What intervention is indicated at any age for patients with progressive symptoms?

Prompt surgical intervention Signup and view all the answers

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 Signup and view all the answers

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 Signup and view all the answers

What is considered the standard of care to guide closure of interatrial communications?

TEE-TRANSESOPHAGEAL ECHOCARDIOGRAPHY Signup and view all the answers

What is characteristic of the electrocardiogram in atrial septal defect (ASD)?

rsR’ pattern in the right precordial leads Signup and view all the answers

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 Signup and view all the answers

What type of VSD is classified as the most common type?

Paramembranous defects Signup and view all the answers

Which functional alteration depends on the size of the ventricular septal defect (VSD)?

Left-to-right shunt Signup and view all the answers

Which of the following is a common complication associated with atrial septal defect (ASD)?

Infective endocarditis Signup and view all the answers

What may be necessary to determine detailed hemodynamics in patients with atrial septal defect (ASD)?

Cardiac Catheterization Signup and view all the answers

What may be necessary if pulmonary hypertension is present in patients with atrial septal defect (ASD)?

Surgery or interventional closure Signup and view all the answers

Which of the following is a clinical manifestation of VSD?

Step up in oxygen saturation at the RV level Signup and view all the answers

What is a common clinical manifestation associated with PDA?

Cyanosis involving the left arm and hand and the lower segment of the body Signup and view all the answers

What is the typical finding in infants with VSD?

Continuous or machinery murmur at the left upper sternal border Signup and view all the answers

What is a common physical examination finding in infants with PDA?

Loud, harsh holosystolic murmur at the lower left sternal border Signup and view all the answers

What diagnostic test permits visualization of most VSD defects of significant size?

Echocardiography Signup and view all the answers

What is a potential complication associated with large VSD defects?

Progressive aortic regurgitation Signup and view all the answers

What is a significant volume overload on the right side of the heart associated with?

Small VSDs Signup and view all the answers

What condition may result from large VSD defects?

Pulmonary vascular disease Signup and view all the answers

Clinical Manifestations of Right-to-Left Shunt

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Questions and Answers

Which type of atrial septal defect is the most common?

What is the major consequence of all types of atrial septal defects?

Which area is affected by ostium primum defect?

What can follow the development of pulmonary hypertension in atrial septal defects?

What is the reason for lower resistance to blood flow across the atrial septal defect with left-to-right shunt?

When does pulmonary hypertension usually develop in patients with atrial septal defects?

Which imaging technique is most valuable for delineating the shunt in patients with a larger ductal defect?

What is a significant complication associated with Coarctation of the Aorta in patients in the second and third decades?

What is a common manifestation of Coarctation of the Aorta in older children?

In which patients is prophylaxis against infective endocarditis appropriate?

What is the most likely finding on ECG for patients with Coarctation of the Aorta?

What kind of defect characterizes Tetralogy of Fallot?

What is a common radiological finding associated with Coarctation of the Aorta?

Which diagnostic test demonstrates LA and LV hypertension and a significant systolic pressure across the coarctation?

What is present in approximately half of patients with Coarctation of the Aorta?

What is indicated in cases where patients do not respond dramatically to decongestive measures for Coarctation of the Aorta?

What is an important feature of Tetralogy of Fallot's pathology?

Which test offers diagnostic confirmation through Doppler flow pattern and gradient estimates for Coarctation of the Aorta?

What is the typical age at which most cases of tetralogy of Fallot are recognized due to cyanosis?

Which symptom is common in individuals with tetralogy of Fallot?

What is the term used for attacks of suddenly increasing cyanosis and hyperpnea that occur in infants and young children with tetralogy of Fallot?

In individuals with tetralogy of Fallot, what is seen in those with cyanosis of more than 3 months’ duration?

What type of murmur is usually audible at the left midsternal border in individuals with tetralogy of Fallot?

What is characteristic in the chest X-ray of individuals with tetralogy of Fallot during childhood?

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?

Which structural components can be demonstrated using echocardiography in tetralogy of Fallot?

What should be frequently evaluated to avoid the development of severe polycythemia or relative anemia in individuals with tetralogy of Fallot?

What is common in individuals with tetralogy of Fallot due to complications of cyanosis and polycythemia?

What position is used for treating hypoxic spells in individuals with tetralogy of Fallot?

What intervention is indicated at any age for patients with progressive symptoms?

Which murmur is most likely to be heard in patients with ostium primum defects?

Which diagnostic test may identify patients with increased pulmonary arterial resistance and shunt reversal in atrial septal defect (ASD)?

What is considered the standard of care to guide closure of interatrial communications?

What is characteristic of the electrocardiogram in atrial septal defect (ASD)?

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?

What type of VSD is classified as the most common type?

Which functional alteration depends on the size of the ventricular septal defect (VSD)?

Which of the following is a common complication associated with atrial septal defect (ASD)?

What may be necessary to determine detailed hemodynamics in patients with atrial septal defect (ASD)?

What may be necessary if pulmonary hypertension is present in patients with atrial septal defect (ASD)?

Which of the following is a clinical manifestation of VSD?

What is a common clinical manifestation associated with PDA?

What is the typical finding in infants with VSD?

What is a common physical examination finding in infants with PDA?

What diagnostic test permits visualization of most VSD defects of significant size?

What is a potential complication associated with large VSD defects?

What is a significant volume overload on the right side of the heart associated with?

What condition may result from large VSD defects?

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