In congenital rubella syndrome, which cardiovascular defect is classically associated?

• A. ASD
• B. VSD
• C. TOF
• D. PDA

Answer: (D)

The key idea is that congenital rubella syndrome classically affects the ductus arteriosus, leaving it open after birth. Rubella infection during early pregnancy disrupts the development and closure mechanisms of the ductus arteriosus, so the vessel fails to constrict and remains patent. Clinically this gives a continuous machinery-type murmur and signs of a left-to-right shunt.

While other heart defects like ASD or VSD can occur in rubella, they are not as characteristic as a persistently open ductus. Tetralogy of Fallot is not typically associated with congenital rubella. The classic rubella-associated cardiovascular finding is patent ductus arteriosus.