11.22 C Flashcards
What are the six types of cardiac pathophysiology?
- pump failure
- flow obstruction
- regurgitant flow
- shunted flow
- disorders of cardiac conduction
- rupture of the heart or major vessel
What are the three major categories of cardiac pathophysiology related to congenital heart disease?
- left to right shunt
- right to left shunt
- obstruction
What are some common causes of congenital left to right shunts?
- atrial septal defects (ASD)
- ventricular septal defects (VSD)
- patent ductus arteriosus (PDA)
What syndromes are most commonly linked to congenital heart disease?
Down syndrome and diGeorge syndrome
The most common genetic cause of congenital heart disease is what?
trisomy 21
The greatest risk factor for a child being born with a congenital heart disease is what?
a parent or sibling having one
Why is Tetralogy of Fallot emphasized so much if it is so rare?
it is the most common congenital heart disease that presents with cyanosis
The most common congential heart disease is what?
a ventricular septal defect
Ventricular septal defects are most commonly the result of a defect in which part of the interventricular septum?
the membranous portion, especially if it is a large defect
How are ventricular septal defects treated?
- most are tolerated well into adulthood and don’t need treatment
- many spontaneously close
- larger ones must be plugged to prevent obstructive pulmonary vascular disease
The biggest problem with large left to right shunts is that they eventually lead to what?
pulmonary hypertension
Babies with large ventricular septal defects often present with what major sign of heart failure?
pulmonary edema
The most important sign that a baby has a ventricular septal defect is what?
that he or she fails to thrive
What is Eisenmenger syndrome?
a complication of a ventricular septal defect in which the left to right shunt becomes a right to left one as the pulmonary vessels constrict to reduce blood flow leading to hypertrophy and increased pressure in the pulmonary system
Eisenmenger syndrome is a complication of what congenital heart disease?
ventricular septal defect
Those with ventricular septal defects show cyanosis when in the course of their disease?
after shunt reversal
What are the three types of atrial septal defects?
- secundum (most common)
- primum
- sinus venosus type
A secundum atrial septal defect results from a deficient what?
septum secundum formation near the center of the atrial septum by the fossa ovalis
Where is a primum atrial septal defect located?
adjacent to the AV valves
Atrial septal defects of the sinus venosus type are located where?
near the entrance of the superior vena cava
What is the age of onset for ASDs?
typically they are asymptomatic until adulthood
Murmurs associated with atrial septal defects are due to what?
excessive flow through the pulmonary valve
Is pulmonary hypertension a sign of ventricular or atrial septal defects?
typically ventricular, not atrial
A boot-shaped cardiac shadow is indicative of what?
Tetralogy of Fallot
Why does Tetralogy of Fallot generate a boot-shaped cardiac shadow?
because of the hypertrophy of the right ventricle
Why is severe cyanosis rare just after birth in those with Tetralogy of Fallot?
because of patent ductus arteriosus
Cyanosis worsens in Tetralogy of Fallot when what happens?
the ductus arteriosus closes up around day 1
What is the diagnostic test for Tetralogy of Fallot?
- put on supplemental oxygen
- won’t have much effect on oxygen levels of a child with ToF
What are the common right to left shunts regarding congenital heart disease?
- tetralogy of fallot
- transposition of the great vessels
How can transposition of the great vessels be treated?
- prostaglandin to keep ductus arteriosus open
- balloon atrial septostomy to enlarge foramen ovale
- surgical correction always necessary
What congential heart disease has a continuous machinery-like murmur?
patent ductus arteriosus
How does a left to right shunt get reversed?
the additional volume and pressure overloads produce obstructive changes in small pulmonary arteries, leading to reversal of flow
If you want to keep the ductus arteriosus open, administer what?
prostaglandin E
What is indomethacin?
a prostaglandin inhibitor given to help closure of the ductus arteriosus
Aortic stenosis is due to what?
a bicuspid aortic valve which causes turbulent flow and microtrauma to the valve leaflets, eventually resulting in calcification and stenosis
