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 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 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
