Learning Cardiology

Q.  In heterotaxy, peripheral blood smear is most likely to show?  A.  Lymphoblasts B.  Spherocytes C.  Howell – Jolly bodies D.  Sickle cells Answer: C. Howell - Jolly bodies Explanation: Right atrial isomerism is associated with asplenia. And, asplenia causes formation of Howell Jolly bodies in the blood. 

Q. Morrow's procedure is used for? A. Ebstein's anomaly B. DCMP C. HOCM D. DORV with VSD Answer: C. HOCM Explanation:  Morrow's procedure is septal myectomy done to relieve the left ventricular outflow tract (LVOT) obstruction and in turn decreases the gradient through LVOT. 

Q. Which of the following is not a feature of Trilogy of Fallot? A. Pulmonic stenosis B. VSD C. ASD D. Right ventricular hypertrophy Answer: B. VSD Explanation:  Trilogy of Fallot - 1. Pulmonic stenosis 2. RVH 3. ASD VSD is not part of Trilogy of Fallot. Tetralogy of Fallot - 1. Pulmonic stenosis 2. RVH 3. Overriding of Aorta 4. VSD Pentalogy of Fallot -  1. Pulmonic stenosis 2. RVH 3. Overriding of Aorta 4. VSD 5. ASD

Q. Most common type of VSD is? A. Muscular B. Perimembranous C. Inlet D. Outlet Answer: B. Perimembranous Explanation: Perimembranous VSD is most common (70%), followed by muscular VSD (24%), doubly committed subarterial VSD (6.4%) and the least common is inlet type of VSD (5.4%).  Reference: https://www.researchgate.net/publication/312590503_Frequency_of_Types_of_Ventricular_Septal_Defect_in_Cardiology  

Q. Most common type of VSD is? A. Muscular B. Perimembranous C. Inlet D. Outlet Answer: Perimembranous VSD

There are three possible arrangements: Solitus (normal) Inversus (mirror image of normal), and Ambiguous (not clearly solitus or inversus ). Here the thoracic and abdominal organs cannot be lateralized and have neither the normal nor mirror image arrangement. CARDIAC ORIENTATION- Relationship or axis of the base to the apex of the heart Levocardia is defined as a normal cardiac position with the cardiac base-to-apex axis pointing from upper right to lower left. Dextrocardia refers to a heart with the base-to-apex axis pointing from the upper left to the lower right. Mesocardia refers to a heart that is usually in the midline with the base-to-apex axis directly from superior to inferior. So, the normal arrangement is Situs Solitus with Levocardia And the mirror image of it is called Situs Inversus with Dextrocardia LAST 3 POINTS ( most important ones actually ) 1) The normal arrangement is Situs Solitus with Levocardia And the mirror image

Q. All of the following predict non-operability in acyanotic congenital heart diseases with increased pulmonary artery pressure except? A. Baseline saturation less than 92% B. PVRI/SVRI >0.3 C. PVRI > 6 woods units/m 2 D. Qp/Qs > 2.0 Answer: D. Qp/Qs > 2.0 Explanation: In acyanotic congenital heart diseases (ASD, VSD, PDA, Complete AVSD) with pulmonary artery hypertension, there is a great dilemma for complete repair of the defect. Because if the patient has developed Eisenmenger syndrome, then he will have a poorer prognosis after surgery. Baseline saturation of less than 92% suggests significant reversal of shunt due to increased PA pressure. During cardiac catheterization study, pulmonary vascular resistance index (PVRI) more than 6 W/m2 and PVRI/SVRI more than 0.3 suggest significantly raised pulmonary artery pressure. These patients might not do well after surgical closure of the defect. For further decision regarding surgery in these cases, vasod

ISOMERISM - The term “isomerism” has been used to describe the combination of atrial situs ambiguity (heterotaxy) and visceral heterotaxy.