240. Congenital Heart and Major Vascular Disease Flashcards
What is the approximate prevalence of congenital heart disease (CHD) in live births?
6/1000 live births
The global burden of CHD remains high.
What factors can impact perioperative risk in children with heart disease undergoing surgery?
Type of surgery, stage of heart defect palliation, case volume at a given center
These factors are crucial in assessing surgical risks.
How can congenital heart disease be broadly classified?
Acyanotic, cyanotic, major vascular disease, pulmonary hypertension (PH)
This classification helps in understanding the different types of heart defects.
What are acyanotic defects?
Left-to-right shunting lesions, obstructive lesions, valvular lesions
Acyanotic defects do not typically result in cyanosis.
What types of lesions are included in the classification of acyanotic congenital heart diseases?
Aortic regurgitation, aortic stenosis, atrial septal defect, coarctation of the aorta, patent ductus arteriosus, among others
A complete list includes various types of lesions affecting blood flow.
What defines cyanotic defects in congenital heart disease?
A wide range of pathology with variable single-ventricular physiology
Cyanotic heart disease often leads to reduced oxygenation of blood.
What is the primary etiology of major vascular disease?
Pathology in embryonic aortic arches 4 and 6
These embryonic developments are crucial in understanding major vascular anomalies.
What are the classifications of coarctation of the aorta?
Preductal, ductal, postductal
Each type presents with different clinical implications and timing of detection.
What is a vascular ring?
Congenital anomalies of the aortic arch complex that can compress the trachea and esophagus
Vascular rings can lead to significant respiratory issues.
How is pulmonary hypertension classified according to the World Health Organization (WHO)?
1) Pulmonary arterial hypertension, 2) PH due to left heart disease, 3) PH due to lung disease and/or hypoxia, 4) Chronic thromboembolic PH, 5) PH with unclear multifactorial mechanisms
This classification aids in understanding the various causes of pulmonary hypertension.
What is a common cause of pulmonary hypertension in children related to lung disease?
Bronchopulmonary dysplasia
This condition is often associated with prematurity.
What factors increase peripheral vascular resistance (PVR)?
Hypoxia, hypercarbia, acidosis, hyperinflation, atelectasis, sympathetic stimulation, high hematocrit levels, surgical constriction
Understanding these factors is critical for anesthetic management.
What factors decrease peripheral vascular resistance (PVR)?
Oxygen, hypocarbia, alkalosis, normal functional residual capacity, blocking sympathetic stimulation, low hematocrit level
These factors can be managed to optimize patient outcomes.
Fill in the blank: Congenital heart disease can be classified into _______.
acyanotic, cyanotic, major vascular disease, pulmonary hypertension
This classification is fundamental in understanding CHD.
