7 - Congenital Heart Defects Flashcards
What are two things that can happen to a baby if mother contracts rubella virus?
- Congenital heart defect
- Congenital deafness
What are the different pressures in each part of the heart?

What is the oxygen saturation in each side of the heart?
- 60-70% in the pulmonary
- 99-100% systemically
If a baby has a right to left shunt how do they survive?
They have the shunt and a distal obstruction, e.g PDA
What are some cyanotic and acyanotic heart defects?
Acyantoic: ASD, VSD, PDA, aortic stenosis, pulmonary stenosis, coarctation of aorta, mitral stenosis
Cyanotic: Tetralogy of Fallot, Transposition of great arteries, Univentrictular Heart
What are some atrial septal defects?
- Most common location is at ostium secundum
- Increased pulmonary blood flow so RV volume overload. Rare to get pulmonary hypertension but right sided heart failure

What is a patent foramen ovale?
- Not a true ASD. Usually clinically silent because the atrial pressure causes functional closure of flap valve
- Issue: tiny blood clots can form and can pass into the lungs where they settle and can lead to stroke

What happens to the anatomy of the heart in a ventricular septal defect?
- Left to right shunt
- Mainly in membranous part
- Pulmonary venous congestion and pulmonary hypertension

What is eisenmenger syndrome?
- Occurs in PDA, VSD, ASD
- More blood being pumped into pulmonary circulation so pulmonary hypertension
- Leads to increased pressure in right side so bidirectional shunt

What is a patent ductus arteriosus?
- Flow of blood from aorta to pulmonary artery
- Can lead to eisenmenger’s

What is the most common heart defect in downs syndrome children?
Atrioventricular septal defects due to failure of endocardial cushions

What is coarctation of the aorta?
- Narrowing of the aortic lumen in area of ligamentum arteriousum (old DA)
- Leads to left ventricle hypertrophy due to increased afterload
- Upper body not usually affected as blood supply prximal to coarctation but weak femoral pulses and upper body hypertension

What is tetralogy of Fallot?
- 4 lesion due to outflow portion of interventricular septum is too far anterior and cephalic
- Over-riding aorta, ventricular septal defect, pulmonary stenosis, right ventricular hypertrophy
- Cyanotic, if mild may only show in adulthood

What is tricuspid atresia?
- Lack of development of the tricuspid valve and small RV
- Must be a complete right to left shunt of all blood returning to right atrium (ASD or PFO) and a VSD or PDA to allow blood flow to lungs
- Can be given prostagladin to keep DA open waiting for surgery to form ASD

What is transposition of the great arteries?
- Swapping of aorta and PA. Not viable unless the two circuits connected. Bi-directional shunting
- Can give prostaglading to keep DA open and then switch the big vessels and coronary arteries when baby is older

What is hypoplastic left heart syndrome?
- Left ventricle and ascending aorta fail to develop
- PFO or ASD present and blood supply to systemic is via PDA
- Right ventricle supporting systemic via R to L shunt

What is fontan circulation?
A way to treat hypoplastic left heart syndrome?
What is a univentricular heart?
- Can be with and without transposition of the great arteries
- Failure of interventricular septum to form
- Need to protect lungs from high pressure

What is pulmonary atresia?
- No development of pulmonary valve
- R to L atrial shunt of venous return
- Blood flow to lungs via PDA

What are some issues related to:
- ASD
- VSD
- Coarctation
- Tetralogy of Fallot
- Transposition/HLHS/Pulmonary Atresia/Coarctation?
- Asymptomatic but late onset arrythmia and right heart failure
- Left heart failur and inoperable pulmonary hypertension eventually
- LV hypertrophy
- Cyanotic spells
- Neonatal blood flow as reduced pulmonary blood flow
What is one of the later symptoms of mitral valve stenosis?
Dysphagia due to dilation of the left atrium and compression of oesophagus
What heart sound would you hear in a patent ductus arteriosus?
Murmur throughout systole and diastole, difficult to hear S2
What is the difference between the course of the left and right reccurent laryngeal nerves in relation to the great vessels?
- Right nerve gets hooked on brachiocephalic trunk
- Left gets hook on ductus arteriosus
