Recurrent respiratory tract infections may occur in all of the following except –
Correct Answer: Tetrology of Fallot
Description: Chest infections are frequent in the following two groups of congenital cardiac anomalies.
a) Left to right shunts → This group includes
Atrial septal defect
Ventricular septal defect
Patent ductus arteriosus
This group of CHD's are characterized by frequent chest infections.
There is large flow of blood in the lungs which causes lung infections.
Each attack of cold seems to turn into Bronchopneumonia.
It is not uncommon for these patients to have 6-8 attacks of pneumonia in the first year of life.
b) Cyanosis with increased pulmonary blood flow.
A large no. of conditions result in a combination of cyanosis with increased pulmonary blood flow.
Common to these conditions is the presence of abnormal mixing of pulmonary venous blood with the systemic venous blood and absence of obstruction to pulmonary blood flow.
The anomalies included in this group are
Transposition of great vessels
Total anomalous pulmonary venous connection
Single ventricle without obstruction to pulmonary blood flow.
Persistent truncus arteriosus
Tricuspid atresia with absence of obstruction to pulmonary blood flow.
Double outlet right ventricle without pulmonary stenosis.
Clinically these patients are characterized by
Cyanosis
Cardiomegaly
Almost 80% of these patients are lost due to congestive cardiac failure or pulmonary infection.
Congenital heart diseases which are not predisposed to pulmonary infection
1) Right to left shunts
This group includes
Tetralogy of Fallot
Ebstein's anamoly
2) Obstructive lesions
This group includes
Aortic stenosis
Coarctation of Aorta
Pulmonary stenosis
Characteristic of this group is
Presence of cyanosis
The absence of chest infections
Clinical characteristic of this group
The absence of frequent chest infections and cyanosis
The absence of a precordial bulge
Presence of forcible or heaving cardiac impulse.
Category:
Pediatrics
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