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Paediatric

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CVS

Question
48 out of 63
 

Commonest type of congenital heart disease is- (LQ)



A ASD
B VSD

C TOF
D PDA

Ans. B

VSD

VSD is the commonest CHD.

VSD is the commonest qcyqnotic CHD.

Acyanotic conqenital heart diseases

o Acyanotic heart disease may be of two types : -

A) Left to right shunts. (ASD, VSD, PDA)

B) Obstructive lesions (PS, AS, Coarctation of aorta).

a. Left to right shunts

Patients with left to right shunts have following features: -

i. Frequent respiratory tract infection -+ because pulmonary circulation is overloaded which may result in pulmonary edema, CIIF and infection.

ii. No cyanosis -->Most of the blood is in pulmonary circulation. So there is no impairment in oxygenation of blood.

iii. Precardial buldge -+ Frequent chest infections with tachypnea causes tlre soft rib cage being drawn inward at the diaphngnetic attachments ofthe ribs. This combined with cardioamegaly gives them a precordial buldge.

iv. Hyperkinetic precordium

v. Delayed diastolic murmur in tricuspid or mitrol area - Due to increased flow through these areas depending on the type of CHDS.

vi. Cardiomegaly with plethoric pulmonary vasculature on chest X-ray Du.eto increased flow through pulmonary circulation (plethoric Tung) there is increased volume overload to left side of heart -, Cardiomegaly.

b. Obstructive lesions

o Obstructive congenital diseases have following features.

i. Absence of frequenl chest infection ) Pulmonary circulation is not overloaded.

ii. Absence of cyanosis -+ No defect in pulmonary oxygenation and there is no shunt where arterial and venous blood can mix.

iii. Absence ofprecardial buldge -->There is no chest infection or Cardiomegaly.

iv. Heaving (forcible) cardiac impulse --; Obstructive lesions cause concentric hyperfiophy of ventricles that produce forcible contraction.

v. Systolic thrill due to systolic ejection murmur - When hypertrophied ventricles forcibly pump the blood through stenotic puknonary or aortic valve, systolic thrill and systolic ejection murmur are produced.

vi. Absence of delayed diastolic murmur in mitral or tricuspid area -+ Blood flow through these area is not increased.

vii. Presence of delayed coresporuling second sound (A, in AS and P2 in PS) -s because prolonged flow through tiese area results in delayed closure of that valve. Normal sized heart and pulmonary vasculature in chest x-ray -+ there is concentric hypertrophy, hypertrophy without dilatation. So, heart size is normal on x-ray.

CVS Flashcard List

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