Cardiovascular Assessment and Management Flashcards

Which congenital heart defect presents with a 'boot-shaped' heart on chest X-ray and cyanosis?

Answer: Tetralogy of Fallot

Tetralogy of Fallot causes right ventricular hypertrophy and decreased pulmonary flow, producing a classic boot-shaped heart on CXR and cyanosis.

A term neonate has differential cyanosis (pink upper body, blue lower body). Which defect is most likely?

Answer: Transposition of the great arteries with PDA

TGA with a right-to-left ductal shunt causes unoxygenated blood to flow to the lower body while oxygenated blood perfuses the upper body.

What is the primary mechanism by which prostaglandin E1 (PGE1) helps a ductal-dependent lesion?

Answer: Maintains or reopens the ductus arteriosus

PGE1 prevents closure of the ductus arteriosus, maintaining pulmonary or systemic blood flow in ductal-dependent congenital heart defects.

A murmur heard at the left upper sternal border in a premature infant, with a bounding pulse and widened pulse pressure, most likely represents:

Answer: Patent ductus arteriosus (PDA)

A PDA produces a continuous machinery murmur at the left upper sternal border with bounding pulses and wide pulse pressure due to left-to-right shunting.

Indomethacin is used to close a hemodynamically significant PDA. What is an important contraindication to its use?

Answer: Necrotizing enterocolitis or compromised renal function

Indomethacin reduces renal and mesenteric blood flow via prostaglandin inhibition, making NEC and renal impairment contraindications to its use.

Which four-extremity blood pressure finding is most consistent with coarctation of the aorta?

Answer: Higher blood pressure in upper extremities than lower extremities by >10 mmHg

Coarctation of the aorta causes upper extremity hypertension and reduced perfusion pressure in the lower extremities, creating a measurable gradient.