Recurrent respiratory tract infections may occur in all of the following except –
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- Ventricular septal defect
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- Tetrology of Fallot
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- Transposition of great arteries
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- Total anomalous venous return
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Chest infections are frequent in the following two groups of congenital cardiac anomalies.
a) Left to right shunts → This group includes
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Atrial septal defect
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Ventricular septal defect
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Patent ductus arteriosus
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This group of CHD’s are characterized by frequent chest infections.
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There is large flow of blood in the lungs which causes lung infections.
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Each attack of cold seems to turn into Bronchopneumonia.
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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
- Right to left shunts
- This group includes
- Tetralogy of Fallot
- Ebstein’s anamoly
- Obstructive lesions
- This group includes
- Aortic stenosis
- Coarctation of Aorta
- Pulmonary stenosis
Characteristic of this group is
- Presence of cyanosis
- Absence of chest infections
Clinical characteristic of this group
- Absence of frequent chest infections and cyanosis
- Absence of precordial bulge
- Presence of forcible or heaving cardiac impulse.