Acyanotic Congenital Heart Disease Flashcards
aetiology?
- ASD
- VSD
- AVSD
- PDA
- Coarctation of aorta
pathology in PDA?
- failure of ductus arteriosus to close
- higher pressure in aorta than pulmonary vessels
- Lā>R shunt
- fluid overload in lungs
- PHT
- RVH ā> LVH
- HF
key risk factor for PDA
prematurity
when does ductus arteriosus normally close?
stops functioning within 1-3days of life and closes completely by 2-3weeks
childhood presentation of PDA
- SOB
- poor weight gain and feeding
- lower respiratory tract infections
- murmur
describe murmur heard in PDA
continuous crescendo-decrescendo murmur heard between clavicles
Mx of PDA?
monitored until 1 y/o with echo. if no spontaneous closure:
- medical
- fluid restriction
- NSAIDs
- surgical closure
conditions where having a PDA is life saving?
- transposition of great arteries
- coarctation of aorta
types of ASD?
- osteum secundum
- patent foramen ovale
complications of ASD?
- stroke from VTE
- AF or Atrial flutter
- PHT & right sided HF
- Eisenmenger Syndrome
childhood presentation of ASD?
may be symptomless or present in adulthood w complications. typical symptoms:
- SOB
- poor feeding / weight gain
- lower respiratory tract infections
- murmur
what is the murmur heard in ASD?
mid-systolic, crescendo-decrescendo murmur loudest at upper left sternal border
+ fixed split second heart sound
Mx of ASD?
- small- conservative
- large & symptomatic- surgical repair
- open heart or transvenous catheter
what must you put adults with an ASD on?
anto-coagulants
childhood presentation of VSD?
may be symptomless or present in adulthood. Typical symptoms:
- SOB
- tachypnoea
- poor feeding / weight gain
- murmur
VSD murmur?
- pan systolic murmur
- lower left sternal border
- may also be a systolic thrill on palpation
Mx of VSD?
surgical repair (open heart or transvenous catheter)
what is there increased risk of with VSD?
Infective endocarditis - give Abx prophylaxis prior to surgery
what is seen structurally in AVSD?
- osteum primum ASD
- high VSD
- single AV valve
what is coarctation of aorta?
narrowing of aortic arch, usually around ductus arteriosus
can vary from mild to severe
presentation of co-arctation in child?
- weak femoral pulses
- higher pressure in upper limbs than lower limbs
- grey, floppy baby
- poor feeding
- tachypnoea
when does coarctation usually present?
around 2-3 weeks when ductus arteriosus closes and baby collapses
Ix of coarctation?
- doppler
- MRI
Mx of coarctation?
prostaglandin E until surgery
