Congenital Heart Disease 2026-2027
Questions With Correct Answers A+ Graded
In patients with ventricular septal defect, the ECG most commonly demonstrates (left/right) -----
ventricular hypertrophy. - CORRECT ANSWER -left
Ventricular septal defect causes a (systolic/diastolic) murmur. - CORRECT ANSWER -pansystolic
murmur
In the absence of pulmonary hypertension, a ventricular septal defect leads to a (right to
left/left to right) shunt. - CORRECT ANSWER -left to right
The murmur of ventricular septal defect is loudest at the _____ - CORRECT ANSWER -left lower
sternal border.
Ventricular septal defect closure is indicated if the pulmonary artery pressure is ranging
between__________ - CORRECT ANSWER -50 and 100 mmHg.
In Eisenmenger syndrome, the ventricular septal defect causes (right to left/left to right)_____ -
CORRECT ANSWER -right to left shunt
In most cases, ventricular septal defects are defects of the (membranous/muscular) _______
portion of the interventricular septum. - CORRECT ANSWER -membranous
In cases of severe pulmonary hypertension due to a ventricular septal defect, surgical repair is
_______ - CORRECT ANSWER -contraindicated
A 5-year-old boy comes to the office because of a routine examination. He is up to date on his
immunizations, but has received little other medical treatment during his life. His mother notes
,that when he was born, she was told that he had a small "hole inside of his heart." She is not
aware of any other health issues, although she does note that he seems to get tired more easily
as of late. Examination shows the boy is afebrile. The point of maximum impulse is displaced
leftward. There is no clubbing or edema visible. Cardiac auscultation shows a I/VI holosystolic
murmur at the lower left sternal border. The lungs are clear to auscultation. Which of the
following is most likely to be observed on chest X-ray? - CORRECT ANSWER -Cardiomegaly
Ventricular septal defect is characterized by worsening fatigue, a holosystolic murmur, and a
displaced point of maximal impulse. Both left and right ventricles are likely to be enlarged in a
patient like this, who has had little medical care.
What is the most common cause of congenital heart disease? - CORRECT ANSWER -VSD
What is VSD associated with? - CORRECT ANSWER -◦ Down Syndrome
◦ Edward's syndrome
◦ Patau syndrome
◦ Fetal alcohol syndrome
◦ Post MI
What is VSD? - CORRECT ANSWER -Defect anywhere in the ventricular septum ,
perimembranous (adjacent to the tricuspid valve) or muscular (completely surrounded by
muscle)
• malformation of the ventricular septal wall resulting in a communication between the left
ventricle and the right ventricle.
What happens in VSD? - CORRECT ANSWER -Oxygenated blood from the L ventricle shunts into
the R ventricle during systole and goes right out to the pulmonary artery, with an increase in the
amount of blood returning to the LV.
Increased volume load on the L ventricle and pulmonary vasculature --> CHF
, The increased volume of blood passing through the RV outflow tract can cause pulmonary
congestion or Eisenmenger's syndrome
Features of patient with VSD - CORRECT ANSWER -• Failure to thrive
• Diaphoresis
• Frequent resp tract infections
Complication of VSD - CORRECT ANSWER -• aortic regurgitation*poorly supported right
coronary cusp resulting in cusp prolapse
• infective endocarditis
• Eisenmenger's complex- RHS to LHS shunt
• right heart failure
• pulmonary hypertension
What type of murmur can be heard in VSD? - CORRECT ANSWER -Pan systolic murmur
Ix for suspected VSD - CORRECT ANSWER -• Echo- gold standard
• CXR- cardiomegaly/ increased pulmonary markings due to congestion
• ECG- left or right ventricular hypertrophy
What is the management of VSD? - CORRECT ANSWER -Small VSD can be left alone for
spontaneous closure
Questions With Correct Answers A+ Graded
In patients with ventricular septal defect, the ECG most commonly demonstrates (left/right) -----
ventricular hypertrophy. - CORRECT ANSWER -left
Ventricular septal defect causes a (systolic/diastolic) murmur. - CORRECT ANSWER -pansystolic
murmur
In the absence of pulmonary hypertension, a ventricular septal defect leads to a (right to
left/left to right) shunt. - CORRECT ANSWER -left to right
The murmur of ventricular septal defect is loudest at the _____ - CORRECT ANSWER -left lower
sternal border.
Ventricular septal defect closure is indicated if the pulmonary artery pressure is ranging
between__________ - CORRECT ANSWER -50 and 100 mmHg.
In Eisenmenger syndrome, the ventricular septal defect causes (right to left/left to right)_____ -
CORRECT ANSWER -right to left shunt
In most cases, ventricular septal defects are defects of the (membranous/muscular) _______
portion of the interventricular septum. - CORRECT ANSWER -membranous
In cases of severe pulmonary hypertension due to a ventricular septal defect, surgical repair is
_______ - CORRECT ANSWER -contraindicated
A 5-year-old boy comes to the office because of a routine examination. He is up to date on his
immunizations, but has received little other medical treatment during his life. His mother notes
,that when he was born, she was told that he had a small "hole inside of his heart." She is not
aware of any other health issues, although she does note that he seems to get tired more easily
as of late. Examination shows the boy is afebrile. The point of maximum impulse is displaced
leftward. There is no clubbing or edema visible. Cardiac auscultation shows a I/VI holosystolic
murmur at the lower left sternal border. The lungs are clear to auscultation. Which of the
following is most likely to be observed on chest X-ray? - CORRECT ANSWER -Cardiomegaly
Ventricular septal defect is characterized by worsening fatigue, a holosystolic murmur, and a
displaced point of maximal impulse. Both left and right ventricles are likely to be enlarged in a
patient like this, who has had little medical care.
What is the most common cause of congenital heart disease? - CORRECT ANSWER -VSD
What is VSD associated with? - CORRECT ANSWER -◦ Down Syndrome
◦ Edward's syndrome
◦ Patau syndrome
◦ Fetal alcohol syndrome
◦ Post MI
What is VSD? - CORRECT ANSWER -Defect anywhere in the ventricular septum ,
perimembranous (adjacent to the tricuspid valve) or muscular (completely surrounded by
muscle)
• malformation of the ventricular septal wall resulting in a communication between the left
ventricle and the right ventricle.
What happens in VSD? - CORRECT ANSWER -Oxygenated blood from the L ventricle shunts into
the R ventricle during systole and goes right out to the pulmonary artery, with an increase in the
amount of blood returning to the LV.
Increased volume load on the L ventricle and pulmonary vasculature --> CHF
, The increased volume of blood passing through the RV outflow tract can cause pulmonary
congestion or Eisenmenger's syndrome
Features of patient with VSD - CORRECT ANSWER -• Failure to thrive
• Diaphoresis
• Frequent resp tract infections
Complication of VSD - CORRECT ANSWER -• aortic regurgitation*poorly supported right
coronary cusp resulting in cusp prolapse
• infective endocarditis
• Eisenmenger's complex- RHS to LHS shunt
• right heart failure
• pulmonary hypertension
What type of murmur can be heard in VSD? - CORRECT ANSWER -Pan systolic murmur
Ix for suspected VSD - CORRECT ANSWER -• Echo- gold standard
• CXR- cardiomegaly/ increased pulmonary markings due to congestion
• ECG- left or right ventricular hypertrophy
What is the management of VSD? - CORRECT ANSWER -Small VSD can be left alone for
spontaneous closure
