Coarctation and the Obstructed Left Heart – 18 Board-Style Cases with Answers

What this deck covers

Coarctation and the Obstructed Left Heart in 18 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.

Board-style teaching questions for paediatricians and trainees preparing for board, MRCPCH and Prometric examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 18 cases, in order

1. Strong at the wrist, faint below
2. Why it is late, not gone
3. Grooves under the bones
4. What comes with it
5. How late it peaks
6. Open it without cutting
7. Fixed, and still high
8. Tired again at six
9. A pulse that falls away
10. Above the valve, and talkative
11. Louder every single year
12. Rarely just one place
13. Football yes, barbell no
14. Sore calves on the run
15. It looked at the wrong thing
16. Two children, opposite answers
17. Cured is the wrong word
18. Well today, and still urgent

Diagnoses and management options tested

Across the 18 cases you are asked to choose between options such as: A twenty-four hour ambulatory recording, Old healed fractures from unrecognised injury, A hole between the atria, Measurement error from a cuff that is too small, Reduced pumping force from the left ventricle, Leakage backwards through the aortic valve, Trisomy 21, in, Thickening of the heart muscle just below the valve, The right-sided valves and the pulmonary arteries, Growing pains, He needs review only until he stops growing, after.

Clinical pearls from this deck

• The leg should read higher than the arm. When it does not, feel the femorals again.
• Weak and late, not absent. The long way round takes time.
• Grooves under the ribs mean years of collateral flow, not an injury.
• Fix the aorta, then watch the valve for the next fifty years.
• Not how loud, but how late. And listen for the second sound disappearing.
• Pliable leaflets buy you a balloon. Save the prosthesis for when he has stopped growing.

Work through the deck once for recognition, then again a week later to test yourself — each question gives the answer and explains why every other option fails.

More from this system: all Cardiology Board Questions case decks · pediatric reference values.