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Pediatrics · Cardiology: heart failure in infancy
Sample itemA 6-week-old with a large VSD has tachypnoea, poor feeding, sweating on feeds and hepatomegaly. What is the usual initial medical therapy?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
D. Furosemide with an ACE inhibitor, with or without digoxin
Heart failure from a left-to-right shunt is treated with diuretics, afterload reduction using captopril or enalapril, and digoxin in some centres. Adequate calories are needed for growth. Definitive treatment is surgical closure of the defect.
Option by option
A. Indomethacin
Indomethacin closes a PDA, not a VSD.
B. Propranolol only
Beta-blockers alone are not first line for acute failure.
C. Antibiotics
Antibiotics do not treat heart failure.
D. Furosemide with an ACE inhibitor, with or without digoxin (correct)
Correct. Diuretics and ACE inhibitors are first line.
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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