Question
Congestive heart failure is seen in all of the following except:
| A. |
TAPVC |
| B. |
TOF |
| C. |
Coarctation of aorta |
| D. |
PDA |
Show Answer
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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.