A condition in which a single vessel overrides both ventricles is called?

SCTIMST Staff Nurse - 2016

Medical Surgical Nursing

Easy

Appeared in: SCTIMST Staff Nurse - 2016

Explanation

Truncus arteriosus is defined as a congenital heart defect where a single arterial trunk originates from the heart, supplying the systemic, pulmonary, and coronary circulations.
A ventricular septal defect (VSD) is always present, and the single trunk overrides this defect, receiving mixed blood from both the right and left ventricles.
This anatomy perfectly matches the description in the question stem and the provided diagram.

Option A: In Transposition of the Great Arteries (TGA), there are two separate great vessels (the aorta and pulmonary artery), but they are connected to the wrong ventricles. The question specifies a 'single vessel'.
Option B: Hypoplastic single ventricle refers to the underdevelopment of a ventricular chamber (e.g., Hypoplastic Left Heart Syndrome). It describes the state of a ventricle, not the configuration of the great arteries.
Option C: Tetralogy of Fallot (TOF) includes an 'overriding aorta,' but it is a condition with two distinct great arteries (the aorta and a stenosed pulmonary artery). It is not a 'single vessel' defect.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Cyanotic Congenital Heart Defects as background academic context rather than a clinical decision trigger.
Nurses caring for an infant with Truncus Arteriosus must closely monitor for signs of congestive heart failure, such as tachypnea, poor feeding, failure to thrive, and hepatomegaly, due to excessive pulmonary blood flow.
Pre-operative nursing care involves managing heart failure with diuretics (like furosemide), optimizing nutrition with high-calorie formula and small, frequent feeds, and preventing infections.
What if? If the infant develops severe cyanosis and respiratory distress shortly after birth, it could indicate associated truncal valve stenosis or early development of pulmonary hypertension, requiring more urgent surgical intervention.

How to Approach the Question

First, identify the key phrases in the question: 'single vessel' and 'overrides both ventricles'. This is the defining characteristic you need to match.
Next, analyze the provided image. Observe that there is only one large artery coming from the top of the heart, positioned over a hole between the two bottom chambers. This visual information strongly supports the 'single vessel' description.
Evaluate each option against this key definition. Ask yourself: 'Does this condition involve a single great artery?'
Eliminate options that describe defects with two great arteries (like TGA and TOF) or defects unrelated to the great arteries (like hypoplastic ventricle).
Select the option that precisely matches the definition of a single common arterial trunk, which is Truncus Arteriosus.

Concept Tested & Keywords

Concept Tested: Cyanotic Congenital Heart Defects
Stem keywords: single vessel, overrides both ventricles
Lead-in keywords: is called
Clinical cues: The provided image of the heart's anatomy is a critical clue, visually defining the condition.

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E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 606-608

E6 Midwifery Obstetrics and Gynecology Nursing Sandeep Kaur p. 26-34