Which of the following is a congenital malformation of the heart?

Raj. CHO -2025

Child Health Nursing (Pediatrics)

Easy

Appeared in: Raj. CHO -2025

Explanation

Patent ductus arteriosus (PDA) is a congenital heart defect where a fetal blood vessel connecting the aorta and pulmonary artery fails to close after birth.
This vessel, the ductus arteriosus, is essential in utero to bypass the fetal lungs.
Its failure to close leads to a left-to-right shunt, where oxygenated blood from the high-pressure aorta flows into the pulmonary artery.
This abnormal flow increases blood volume to the lungs, causing pulmonary congestion and increased workload on the heart.
A characteristic 'machinery-like' murmur is a key clinical sign of PDA.

Option A: Cleft lip is a congenital malformation, but it affects the structure of the face (specifically the upper lip), not the heart.
Option C: Spina bifida is a congenital malformation, but it is a neural tube defect affecting the spinal column and spinal cord, not the heart.
Option D: Polydactyly is the condition of being born with extra fingers or toes. While congenital, it is a limb anomaly, not a heart defect.

Visual 1: Diagram - A comparison of normal postnatal circulation versus circulation with a Patent Ductus Arteriosus. The diagram should clearly show the aorta, pulmonary artery, and the open ductus arteriosus with an arrow indicating the abnormal left-to-right blood flow.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Identification of congenital heart malformations as background academic context rather than a clinical decision trigger.
Nurses play a crucial role in the early detection of congenital heart defects by performing thorough newborn assessments. Auscultating for murmurs, checking for differential pulses (bounding pulses in PDA), and monitoring for signs of respiratory distress or poor feeding are key nursing actions.
Management of PDA depends on its size and the infant's symptoms. Small PDAs may close on their own, while larger ones may require medical management with prostaglandin inhibitors (like indomethacin or ibuprofen) or surgical/catheter-based closure.
What if? If an infant has another complex heart defect, such as transposition of the great arteries, keeping the ductus arteriosus open with prostaglandin E1 can be a life-saving measure until corrective surgery can be performed. In this case, the PDA provides essential mixing of blood.

How to Approach the Question

First, carefully read the question and identify the key concepts: 'congenital malformation' and 'of the heart'.
Understand that 'congenital' means present at birth.
Evaluate each option to determine if it is a congenital defect and, more specifically, if it affects the heart.
Option A (Cleft lip) is a facial defect.
Option C (Spina bifida) is a spinal/neural tube defect.
Option D (Polydactyly) is a limb defect.

Concept Tested & Keywords

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