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Anatomy · Embryology: heart development
Sample itemA cyanotic newborn has an egg-on-string heart shadow on chest radiograph. Echocardiography shows the aorta arising from the right ventricle and the pulmonary trunk from the left ventricle. What is the embryological defect?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
A. Failure of the aorticopulmonary septum to spiral
The aorticopulmonary septum normally follows a spiral course, so that the aorta connects to the left ventricle and the pulmonary trunk to the right. If it descends straight, the great arteries are transposed, giving two parallel circulations that need a shunt to survive.
Option by option
A. Failure of the aorticopulmonary septum to spiral (correct)
Correct. A straight septum produces transposition of the great arteries.
B. Anterosuperior displacement of the infundibular septum
Anterosuperior displacement of the infundibular septum causes tetralogy of Fallot.
C. Complete absence of the aorticopulmonary septum
Complete absence of the septum causes persistent truncus arteriosus with a single outflow vessel.
D. Failure of the endocardial cushions to fuse
Failure of the endocardial cushions to fuse causes an atrioventricular septal defect.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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