An example of a congenital cyanotic heart disease is?

VSSC Nursing Officer - 2021

Child Health Nursing (Pediatrics)

Easy

Appeared in: VSSC Nursing Officer - 2021

Explanation

Tetralogy of Fallot (TOF) is a classic example of a congenital cyanotic heart disease.
It is characterized by four specific heart defects that, in combination, cause deoxygenated (blue) blood from the right ventricle to shunt into the systemic circulation.
This right-to-left shunting of blood bypasses the lungs, leading to lower oxygen levels in the arterial blood and visible cyanosis (a bluish tint to the skin, lips, and nail beds).

Option A: This is an acquired heart disease, not a congenital one. It develops as a complication of rheumatic fever, which is caused by a streptococcal infection.
Option B: A VSD is a congenital defect, but it is typically acyanotic. The higher pressure in the left ventricle causes a left-to-right shunt, meaning oxygenated blood flows back to the lungs, without causing cyanosis.
Option C: While it can be a congenital defect, aortic stenosis is an obstructive lesion, not a cyanotic one. It obstructs blood flow from the left ventricle to the aorta but does not cause deoxygenated blood to enter the systemic circulation.

Clinical Relevance

Nursing practice connection: Knowing Classification of congenital heart diseases into cyanotic and acyanotic types helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Nurses must be able to recognize signs of cyanosis and understand the underlying pathophysiology to provide appropriate care for infants with congenital heart disease.
A key nursing responsibility is managing hypercyanotic episodes, or 'Tet spells,' which are life-threatening events requiring immediate intervention like placing the infant in a knee-chest position to increase systemic vascular resistance.
Patient and family education is critical, covering topics like feeding strategies to conserve energy, recognizing signs of worsening cyanosis, and the importance of long-term cardiac follow-up.

How to Approach the Question

First, identify the key terms in the question: 'congenital' (present at birth) and 'cyanotic' (causing blue discoloration due to low oxygen).
Next, evaluate each option based on these two criteria.
Eliminate 'Rheumatic heart disease' as it is acquired, not congenital.
Consider the direction of blood shunting for the remaining options. Cyanotic diseases involve a right-to-left shunt (deoxygenated blood bypasses the lungs).
Recall or deduce that VSD and Aortic Stenosis are typically acyanotic (left-to-right shunt or obstruction, respectively).
Identify Tetralogy of Fallot as the classic example of a cyanotic (right-to-left shunt) congenital heart disease.

Concept Tested & Keywords

Concept Tested: Classification of congenital heart diseases into cyanotic and acyanotic types.
Stem keywords: congenital, cyanotic, heart disease
Lead-in keywords: example of
Negative lead-in flag: false

QPuJkakUEHtyfqXXZ4avkw

E6 Pathology- ROBBINS & COTRAN PATHOLOGIC BASIS OF DISEASE 10TH Ed pp. 541-543, 542-544

E6 Medicine Harrison 22e Part 1 p. 2114-2116