Lecture 4.1 - Congenital heart diseases

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Questions and Answers

What is the primary method of detection for congenital heart defects in the prenatal period?

Electrocardiogram (ECG)

Magnetic Resonance Imaging (MRI)

Fetal echocardiogram

Prenatal ultrasound (correct)

Which of the following congenital heart defects is characterized by a left-to-right shunt and increased pulmonary blood flow?

Coarctation of the Aorta

Tetralogy of Fallot

Atrial Septal Defect (correct)

Patent Foramen Ovale

What is the common feature of congenital heart defects such as Atrial Septal Defect, Ventricular Septal Defect, and Patent Ductus Arteriosus?

Right-to-left shunt

Increased pulmonary blood flow (correct)

Cyanosis

Decreased cardiac output

What is the primary reason why congenital heart defects do not typically cause cyanosis in the fetal period?

The placenta provides adequate oxygenation Signup and view all the answers

Which of the following syndromes is a common cause of congenital heart defects, including Atrial Septal Defect and Ventricular Septal Defect?

Down syndrome Signup and view all the answers

What is the typical gestational age at which congenital heart defects are screened for?

20 weeks Signup and view all the answers

What is the primary reason for right ventricular dilation in patients with Atrial Septal Defect?

Excess blood in the right atrium and right ventricle Signup and view all the answers

Which of the following is a characteristic of Primum ASD?

Septum primum doesn't reach septum intermedium Signup and view all the answers

What is the effect of increased pulmonary artery hypertension on the lungs?

Blood leaks out of pulmonary arteries and excess fluid flows into the lungs Signup and view all the answers

What is the difference between Atrial Septal Defect and Patent Foramen Ovale?

Atrial Septal Defect occurs when the foramen ovale doesn't close, while Patent Foramen Ovale is a defect in the septum primum Signup and view all the answers

What is the cause of dyspnoea in patients with Atrial Septal Defect?

Blood in the lungs due to pulmonary oedema Signup and view all the answers

What is the characteristic murmur heard in patients with Atrial Septal Defect?

Systolic ejection murmur Signup and view all the answers

Which of the following is a risk factor for Atrial Septal Defect?

All of the above Signup and view all the answers

What is the consequence of increased venous congestion in patients with Atrial Septal Defect?

Raised JVP and hepatomegaly Signup and view all the answers

What is the characteristic murmur of a ventricular septal defect?

Holosystolic murmur at the apex Signup and view all the answers

What is the consequence of a large ventricular septal defect?

Dilation of the left atrium and left ventricle Signup and view all the answers

What is the effect of a ventricular septal defect on pulmonary artery pressure?

It increases pulmonary artery pressure Signup and view all the answers

What is the common feature of a patent ductus arteriosus and a ventricular septal defect?

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

What is the mechanism that keeps the ductus arteriosus open in a patent ductus arteriosus?

Prostaglandins Signup and view all the answers

What is the characteristic of a small ventricular septal defect?

It creates a loud murmur Signup and view all the answers

What is the consequence of a patent ductus arteriosus?

Increased pulmonary artery pressure and left heart dilation Signup and view all the answers

What is the most common congenital cardiac malformation?

Ventricular septal defect Signup and view all the answers

Study Notes

Congenital Heart Defects

Present from birth, detected through prenatal ultrasound (~30 years) at 20 weeks gestation
Can be classified as cyanotic and acyanotic
Most defects permit months of intrauterine life, resulting in live offspring at full term

Acyanotic Congenital Heart Defects

Characterized by left-to-right shunt, where oxygenated blood flows to deoxygenated blood
Does not cause cyanosis
Increased pulmonary blood flow
Common causes: Down syndrome, Foetal alcohol syndrome, Intrauterine infections
May lead to stroke due to increased risks of blood clotting (paradoxical clot formation)

Ventricular Septal Defect (VSD)

Membranous VSD (more common) and Muscular VSD
Most common congenital cardiac malformation
Left-to-right shunt, increased pulmonary artery hypertension (PAH)
Large defects may lead to dilation of left atrium and left ventricle (displaced apex beat)
Ventricular preload increases
Holosystolic (or pansystolic) murmur at the left sternal angle, loud S2, and diastolic rumble (apical)
Excess blood flowing through the mitral valve can be felt at the left sternal border
Smaller VSDs create larger murmurs and vice versa

Patent Ductus Arteriosus (PDA)

Blood from the aorta crosses the ductus arteriosus and flows into the pulmonary artery
Continuous 'machinery' murmur best heard below the left clavicle
Increased pulmonary artery pressure
Left heart dilation (displaced apex beat) and volume overload
Prostaglandins keep the ducts open

Atrial Septal Defect (ASD)

Primum ASD, Secundum ASD (more common), and Sinus venosus defects
Most common congenital heart defects found in adults
Left-to-right shunt, excess blood in the right atrium and right ventricle
Right ventricular dilation: parasternal heave, reduced CO, sympathetic activation
Increased pulmonary artery hypertension (PAH) and pulmonary oedema
Dyspnoea, recurrent chest infections, increased venous congestion, and raised JVP
Systolic ejection murmur, fixed splitting of S2, and diastolic rumble
Surgical repair may be necessary if volume is significant

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Description

This quiz covers congenital heart defects, which are present from birth and can be detected through prenatal ultrasound. Learn about the detection and classification of these defects.