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Year 2 Cardiovascular > Acyanotic heart disease > Flashcards

Acyanotic heart disease Flashcards

1
Q

what are the left to right shunt defects?

A

ASD
VSD
PDA
AVSD

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2
Q

why do holes in the heart create left to right shunts?

A

pulmonary vascular resistance is less than systemic vascular resistance

LV is not working efficiently - oxygenated blood is directed back to lungs

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3
Q

which type of ASD is most common? where does it occur, specifically?

A

secundum type

foramen ovale

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4
Q

what is the pathophysiology of ASD?

A

left to right shunt at atrial level causes volume overload of RA, RV, and lungs

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5
Q

which ventricle is more compliant in ASD? what is the significance / result?

A

RV

easier left to right shunting

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6
Q

what are the auscultation findings (3) of ASD?

A
  1. soft pulmonary ejection murmur from increased flow across normal valve
  2. soft diastolic murmur from increased flow across tricuspid valve
  3. second heart sound widely split, fixed
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7
Q

what are the EKG findings of ASD?

A

right atrial enlargement
right axis deviation
possible right ventricular hypertrophy

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8
Q

what are the CXR findings of ASD?

A

increased pulmonary vascularity
enlarged heart size
large pulmonary artery segment

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9
Q

what is the most common form of congenital heart disease?

A

VSD

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10
Q

what is the most common type of VSD?

A

perimembranous

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11
Q

what is the pathophysiology of VSDs?

A

volume overload to pulmonary artery, lungs, LA, and LV

large defects cause pressure overload of lungs

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12
Q

which chambers / vessels are volume loaded in VSD?

A

pulmonary artery
LA
LV

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13
Q

what can cath data show for VSD risk (3)?

A
  1. size and pressure gradient
  2. pulmonary and systemic blood flow (QP/QS) - ratio greater than 1 is bad
  3. pulmonary vascular resistance
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14
Q

what is the reason for delay in auscultation of a murmur in VSD?

A

depends on ratio of PVR to SVR - could develop over first two weeks

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15
Q

what are the findings of a small VSD on EKG?

A

normal

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16
Q

what are the findings of a large VSD on EKG?

A

LVH, LAE

17
Q

what are the findings of VSD on CXR?

A

cardiomegaly

increased pulmonary vasculature

18
Q

what are the treatment options (3) for CHF seen during VSD?

A

digoxin
diuretic (lasix)
ACE inhibitor

19
Q

what is the pathophysiology of PDA?

A

left to right shunt because PVR less than SVR

20
Q

what are the sequalae of a large PDA?

A

CHF, poor weight gain, respiratory problems

21
Q

what are the physical exam findings for PDA?

A

tach
bounding peripheral pulses with wide pulse pressure
machinery murmur at LUSB

22
Q

what agent is used to close PDAs?

A

indomethacin (PG synthase inhibitor)

23
Q

what is the anatomical defect in AVSD?

A

lower portion of atrial septum and inlet portion of ventricular septum are missing

24
Q

which CHD is associated with down syndrome?

A

AVSD

25
Q

patients with down syndrome have what major congenital heart defect?

A

AVSD

26
Q

what EKG finding is highly suggestive of AVSD?

A

left superior axis at birth

27
Q

when are ventricular outflow obstruction murmurs present?

A

at birth

28
Q

what is the pathophysiology / findings (4) of pulmonary stenosis?

A
  1. elevated RV pressure to force blood across stenotic valve
  2. RV hypertrophy
  3. possible tricuspid regurgitation
  4. right sided heart failure
29
Q

what is the preferred surgical repair for pulmonary stenosis?

A

balloon valvuloplasty

30
Q

what is the pathophysiology of aortic stenosis?

A

elevated LV pressure to force blood across stenotic valve
LV hypertrophy
possible mitral rergurg
left sided heart failure

31
Q

what are the features of auscultation for aortic stenosis?

A

systolic thrill at RUSB
systolic click heard toward apex
ejection murmur heard at midsternal border

32
Q

what is the pathophysiology of coarctation of the aorta?

A

obstruction of flow distal to origin of right and sometimes left subclavian artereis
LV generates increased pressure to force blood across stenosis

33
Q

which BP is higher in coarctation of the aorta - arm or leg?

A

arm

34
Q

what are the EKG findings of coarctation in adults?

A

LVH

35
Q

what are the EKG findings of coarctation in children?

A

RVH

36
Q

what is the medical management for coarctation of the aorta?

A
  1. IV infusion of PGs to maintain ductal patency

2. anti-congestive medications

Year 2 Cardiovascular (43 decks)

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