MCQ – 51935

Congestive heart failure is seen in all of the following except: 

A.	TAPVC
B.	TOF
C.	Coarctation of aorta
D.	PDA

Show Answer

Correct Answer » B Explanation

Congestive heart failure develops when there is volume overload, pressure overload, or impaired myocardial function.

Tetralogy of Fallot (TOF) is primarily a cyanotic congenital heart disease with right ventricular outflow tract obstruction, resulting in reduced pulmonary blood flow. Since there is no significant left-to-right shunt causing volume overload, congestive heart failure is uncommon in classical TOF.

Heart failure may occur only in special situations, such as:

• Severe anemia
• Infective endocarditis
• Associated large Patent Ductus Arteriosus (PDA)
• Associated Aortopulmonary (AP) collateral vessels

Therefore, among the given options, TOF is the exception.

Why the Other Options Are Incorrect

A. Total Anomalous Pulmonary Venous Connection (TAPVC)

• Correct statement (CHF can occur).
• In unobstructed TAPVC, excessive pulmonary blood flow leads to volume overload and congestive heart failure.
• Obstructed TAPVC presents predominantly with severe cyanosis and pulmonary edema.

C. Coarctation of the Aorta

• Correct statement (CHF can occur).
• Critical coarctation in neonates presents with:
  • Poor feeding
  • Tachypnea
  • Shock
  • Congestive heart failure after ductal closure.

D. Patent Ductus Arteriosus (PDA)

• Correct statement (CHF can occur).
• A large PDA produces a significant left-to-right shunt, resulting in:
  • Pulmonary overcirculation
  • Left atrial and left ventricular volume overload
  • Congestive heart failure during infancy.