18- Pericarditis and Congential Heart Disease Flashcards
Beck’s triad
- low arterial blood pressure
- JVD
- distant, muffled heart sounds
Paradoxous pulse
a drop of > 10 mmHg in arterial blood pressure on inspiration
3 causes of constrictive pericarditis
- metastatic neoplasia
- tuberculosis
- organization of purulent pericarditis
most disorders from faulty embryogenesis occur in weeks
3-8
most common congenital heart diseases
- VSD (43%)
- ASD (10%)
- Pulmonary stenosis
- PDA
what percentage of congenital cardiovascular malformations are diagnosed in first year of life
half
abnormal communication or opening between cardiac chambers and/or blood vessels thru which abnormal blood flow will occur
shunt
an abnormal narrowing causing partial obstruction to normal blood flow
stenosis
failure of normal anatomic feature, usually a cardiac valve, to form or develop to a functionally adequate state
atresia
initially noncyanotic then later cyanotic (eisenmenger syndrome)
L->R shunt
cyanotic CHD
R -> L shunt
ASD
VSD
PDA
L-> R shunts
clubbing of tips of the fingers and toes
R–> L shunt
eisenmenger syndrome
pulmonary vascualr resistance approaches systemic levels, thereby producing a new right to left shunt that introduces unoxygenated blood into the systemic circulation
90% of all ASDs are classified as
secundum
deficient or fenestrated oval fossa near the center of the atrial septum
near top = venosus
near bottom = primum
essentially a hole in the center of the heart
complete AVSD
most common right to left shunt
tetralogy of fallot
tetraolgy of fallot
- obstruction of the right ventricular outflow tract (subpulmonary stenosis)
- right ventricular hypertrophy
- aorta that overrides the VSD
- large VSD
enlarged, “boot-shaped” heart
tetralogy of fallot
is there lung damage with tetralogy of fallot?
no - pulmonary stenosis protects pulmonary arteries from HTN PVD
the aorta arises from the RV and lies anterior and to the right of the pulmonary artery, which emanates from the LV
transposition of the Great Arteries
TGA and VSD =
better prognosis, this is a more stable shunt
is coarctation of the aorta more common in females or male
males (2:1)
observe: cyanosis lower half of the body
coarctation of the aorta with a patent ductus arteriosus
w/o PDA would be asymptomatic
observe notched ribs on xray
coarctation of the aorta
