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Question of the Week

Question: A patient comes to your clinic for preconception counseling. She has a recently diagnosed cardiac condition that she will be seeing a cardiologist for next week. She tells you that when her mom was pregnant she also had a cardiac problem that caused some cyanosis during her pregnancy. Of the following cardiac conditions, which one can you assure her will not cause cyanosis?

A. Ventricular Septal Defect
B. Patent Ductus Arteriosus
C. Tetralogy of Fallot
D. Ebstein's Anomaly
E. Marfan's Syndrome

Answer Explained

Marfan's Syndrome is the only condition NOT associated with shunting of blood. It is an inherited weakness of connective tissue that commonly leads to aortic dilation and dissecting aneurysm.

Incorrect answers include: Ebstein's Anomaly - condition with downward displacement of an abnormal tricuspid valve into the right ventricle. Cyanosis is due to right-to-left shunting through the foramen ovale. Tetralogy of Fallot is a combination of pulmonary valve stenosis, right ventricular hypertrophy, an overriding aorta, and VSD with shunting of blood. Cyanosis gets worse during pregnancy when peripheral resistance decreases and the shunt increases. PDA also allows right-to-left shunting when systemic pressure falls. VSD will allow right-to-left shunting when pulmonary hypertension develops.

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Question of the Week

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