4 Congenital Heart Disease Flashcards
Difference between cyanotic and acyanotic heart defects
Cyanotic: central cyanosis due the mixing of oxygenated and deoxygenated blood in the heart causing 🔽 pO2 of systemic blood
-blue discolouration to face, mouth, tongue in babies
Acyanotic: pO2 of blood in the systemic circulation is maintained
What are the common types of Acyanotic Heart Defects
Patent Ductus Arteriosus (PDA)
Atrial Septal Defect (ASD)
Ventricular Septal Defect (VSD)
Atrioventricular Septal Defect (AVSD)
Aortic/Pulmonary Stenosis
Coarctation of the Aorta
What are the common types of Cyanotic Heart Defects
Tricuspid Atresia
Pulmonary Atresia
Transposition of the Great Arteries
Tetralogy of Fallot
Hypoplastic Left Heart
Univentricular Heart
What are the conditions that involve Left to right shunts
ASD
VSD
PDA
Describe ASD
An opening in the septum/wall between the two atria
-🔼pulmonary blood flow (outflow from RA)
-RV volume overload
-Pulmonary hypertension is rare
-Eventual RH failure
Describe VSD
An abnormal opening in the interventricular septum
-mostly occurs in the membranous portion of septum
-Left to right shunt
-Pulmonary Venous congestion (🔼pulmonary blood volume)
-Eventual pulmonary hypertension
Describe AVSD
A hole in the middle of the heart with one common atrioventricular valve, instead of a mitral & pulmonary valve
Cause: failure of the endocardial cushions to develop properly
Describe Aortic/Pulmonary Stenosis
One/both semilunar valves don’t develop properly and are narrow when the baby is born
-aortic valve: valve has only two leaflets
-Results in left/right ventricular hypertrophy as the heart is having to generate more force to push blood through stenosed valve
-Heart failure
Describe Coarctation
Narrowing of part of the aorta, commonly around the ductus arteriosus area
Upstream: 🔼BP (risk of aneurysm of aortic arch, aortic root dilation➡️aortic valve perfusion)
Downstream: 🔽perfusion (weak pulses and claudication)
Narrowing …
1. after three branches of the arch of aorta
-Radial-femoral delay
2. between the brachiocephalic trunk and left subclavian
-Radial-radial delay
Symptoms: radio-femoral delay, strong radial pulses, weak femoral pulses
Describe PDA
Ductus arteriosus (connecting the right pulmonary artery to the arch of aorta) remains open
-blood under higher pressure flows into the pulmonary artery from the aorta
-🔼volume of blood in pulmonary artery→🔼afterload for the RV→right sided heart failure
Describe Tricuspid Atresia
Tricuspid valve fails to form
-Blood can’t flow from RA to RV
-ASD &VSD in babies which allows blood to flow into the pulmonary circulation
ASD: allows mixing of blood and results in a low pO2 →central stenosis
Describe Pulmonary Atresia
Pulmonary valve fails to form
-only way for blood to leave the right-hand side is via a septal defect
VSD: allows deoxygenated blood to move from RV to LV where it mixes with oxygenated blood
PDA: in babies, allow blood into pulmonary c.
Describe the Transposition of the Great Arteries
Aorticopulmonary septum forms, but doesn’t spiral
→aorta arises from RV, pulmonary arises from LV
-pulmonary c. and systemic c. are almost separate, only allowing oxygenated blood to enter systemic c. via ASD & PDA
Treatment: Prostaglandins (to maintain the PDA & allow oxygenated blood into the systemic c. until surgery can be performed)
Describe the Tetralogy of Fallot
Four defects present together
1. Pulmonary stenosis
2. Overriding aorta (aorta is large & next to the VSD)
3. Ventricular septal defect
4. Hypertrophy of RV
Describe the Hypoplastic Left Heart
Mitral/aortic valves are stenosed in utero
-less blood flows into LV →LV underdeveloped
ASD: allows blood to flow into the right side of the heart and be pumped into the pulmonary artery
PDA: allows blood to enter the aorta from the left pulmonary artery
