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Cardiovascular System > 4.1 Congenital heart defects > Flashcards

4.1 Congenital heart defects Flashcards

1
Q

What 4 things can cause congenital heart defects?

A

Genes
Environment
Drugs
Maternal infections

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2
Q

What 2 screening methods are used to detect congenital heart defects?

A

Prenatal ultrasound
Foetal echocardiogram

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3
Q

What are the 3 cyanotic congenital heart defects?

A

Tetralogy of Fallot

Transposition of the great arteries

Eisenmenger syndrome

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4
Q

What are the 3 left-to-right shunt defects?

A

ASD
VSD
PDA

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5
Q

What are the 3 obstruction defects?

A

Congenital aortic stenosis
Pulmonic stenosis
Coarctation of aorta

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6
Q

What is the most common ASD and where is it located on the septum?

A

Secundum ASD located on the fossa ovalis

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7
Q

How does an ASD cause Eisenmenger syndrome?

A

Left-to-right shunt causes RV overload.

This causes pulmonary hypertension and pressure in RV increases to be higher than pressure in LV, so shunt reverses.

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8
Q

What are the symptoms of an ASD?

A

Shortness of breath on exertion
Palpitations
Repeated respiratory infections

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9
Q

What do you see in physical examination of an ASD?

A

Parasternal heave

Murmur at upper-left sternal border (due to increased blood flow across PV)

Murmur at lower-left sternal border (due to increased blood flow across TV)

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10
Q

What is patent foramen ovale?

A

When the foramen ovale doesn’t disappear after birth

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11
Q

When is patent foramen ovale clinically relevant?

A

When RV pressure is higher than LV pressure - patent foramen ovale acts as right-to-left shunt

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12
Q

Where does the most common VSD occur?

A

Membranous portion of the interventricular septum

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13
Q

What are the symptoms of a VSD?

A

Small VSDs are symptom-free

Large VSDs cause symptoms of heart failure

Repeated respiratory infections

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14
Q

What do you see in physical examination of a VSD?

A

Holosystolic murmur at left sternal border

Systolic thrill at left sternal border

Apical mid-diastolic rumble murmur

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15
Q

What is patent ductus arteriosus (PDA)?

A

When the ductus arteriosus doesn’t disappear after birth

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16
Q

What are the symptoms of PDA?

A

Small PDA is symptom-free

Moderate PDA has AF, fatigue, dyspnoea and palpitations

Large PDA has heart failure, tachycardia, and can cause Eisenmengers where only lower extremities have cyanosis

17
Q

What do you see in a physical examination of PDA?

A

Machine-like murmur in left subclavicular region

Cyanosis of only lower extremities if Eisenmengers happens

18
Q

What is aortic stenosis?

A

When calcification or fibrosis causes reduced blood flow through the aortic valve.

19
Q

What are the 3 classes of aortic stenosis?

A

Valvular (in the valve)
Subvalvular (below the valve)
Supravalvular (above the valve)

20
Q

What are the symptoms of aortic stenosis?

A

LV hypertrophy
Fatigue
Dyspnoea on exertion
Angina
Syncope (fainting)

21
Q

What do you see in a physical examination of aortic stenosis?

A

Crescendo-decrescendo murmur

22
Q

What is pulmonic stenosis?

A

Stenosis of the pulmonary artery

23
Q

What are the symptoms of pulmonic stenosis?

A

RV hypertrophy
Dyspnoea on exertion
Exercise intolerance
Pedal oedema (swelling of feet)

24
Q

What do you see in a physical examination of pulmonic stenosis?

A

Parasternal heave over sternum

Early systolic ejection murmur in upper left sternal border

Splitting of S2 heart sound

Prominent A-wave on JVP

25
Q

What is coarctation of the aorta?

A

Narrowing of aortic tube at the ductus

26
Q

What is the symptom of coarctation of the heart?

A

LV hypertrophy (from increased afterload in LV)

27
Q

What do you see in a physical examination of coarctation of the heart?

A

Mid-systolic ejection murmur

Weak femoral pulse

High blood pressure in upper body

28
Q

What 4 things happen in tetralogy of fallot?

A

VSD
Pulmonary valve stenosis
RV hypertrophy
Aortic displacement to middle of septum

29
Q

What are the symptoms of tetralogy of fallot?

A

Dyspnoea on exertion
Progressive cyanosis
Syncope
Hyperventilation

30
Q

What do you see in a physical examination of tetralogy of fallot?

A

Parasternal heave

Cyanosis of digits, lips and mucus membranes

31
Q

What is pulmonary atresia?

A

When the pulmonary valve is completely blocked.

There is a VSD and the aorta is displaced to the middle of the septum.

Blood enters pulmonary artery through aorta via patent ductus arteriosus

32
Q

What are the symptoms of pulmonary atresia?

A

Dyspnoea
Heart failure
Cyanosis
Arrhythmias

33
Q

What would you see in a physical examination of pulmonary atresia?

A

Splitting of S2 heart sound

34
Q

What is transposition of the great vessels?

A

When the aorta and pulmonary artery are swapped.

35
Q

What is the treatment for all the other congenital heart defects

A

Surgery

36
Q

What is the treatment for PDA

A

Constriction of ductus with prostaglandin synthesis inhibitors

Surgery

37
Q

What is the treatment for pulmonic stenosis?

A

No treatment unless serious

Then you do surgery

38
Q

What is the treatment for VSDs

A

50% close on their own

50% require surgery

Cardiovascular System (1 decks)

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