Question
Which of the following congenital anomalies leads to heart failure at birth?
| A. |
Total anomalous pulmonary venous connection
|
| B. |
Transposition of great arteries
|
| C. |
Pulmonary atresia
|
| D. |
Coarctation of aorta
|
Show Answer
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Correct Answer » A
Explanation
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|
- Total Anomalous Pulmonary Venous Connection (TAPVC) is a congenital anomaly in which all pulmonary veins drain into the systemic venous circulation instead of the left atrium.
- In obstructed TAPVC, pulmonary venous obstruction causes:
- Severe pulmonary venous hypertension
- Pulmonary edema
- Respiratory distress
- Congestive heart failure presenting at birth or within the first few hours of life
- It is one of the few congenital heart diseases that can produce heart failure very early in the neonatal period.
Why the Other Options Are Incorrect
B. Transposition of the Great Arteries (TGA)
- TGA usually presents with severe central cyanosis soon after birth.
- Congestive heart failure is not the predominant initial presentation unless there is a large left-to-right shunt or delayed presentation.
C. Pulmonary Atresia
- Pulmonary atresia presents with severe cyanosis due to markedly reduced pulmonary blood flow.
- Pulmonary circulation is duct-dependent.
- Congestive heart failure is not the usual presentation at birth.
D. Coarctation of the Aorta
- Neonates with critical coarctation usually become symptomatic after closure of the ductus arteriosus (typically 2–7 days after birth).
- They present with:
- Poor feeding
- Shock
- Metabolic acidosis
- Congestive heart failure
- Therefore, heart failure is not typically present at birth.
