Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

cardiology > acyanotic lesions > Flashcards

acyanotic lesions Flashcards

1
Q

VSD and ASD: pressure vs volume

A

VSD is pressure overload

ASD is volume overload (not as bad)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

types of ASD - which is most common

A

1) secundum (60%) - anomalous pul return in 10%
2) primum (30%)
3) sinus venosus (10%) - anomalous drainage in SVC/IVC
4) coronary sinus - rare

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

ASD vs PFO shunts

A

PFO doesnt usually cause intra-cardiac shunts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

T21 a/w which ASD

A

primum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

which is closer to the AV node - primum or secundum ASD

A

primum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

ASD vs VSD shunt magnitude determined by what two factors

A

ASD A) size of defect and B) compliance of ventricle

VSD A) size of defect and B) PVR (lower then PVR, more shunt)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

why does CHD/pulmonary HTN develop so late in ASDs?

A

not pressure issue - there’s no direct transmission of systemic pressures
pulmonary arteries can handle the increased volume for quite some time, with normal PA pressures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

classic murmur findings in ASD (3) vs VSD (4)

A

ASD:

  1. fixed split of S2 (more pulmonary flow)
  2. grade 2-3 ejection systolic at LUSE - get a RELATIVE pulmonary stenosis due to inc flow
  3. mid diastolic rumble sometimes - can be a/w tricuspid stenosis

VSD:

  1. holosystolic murmur LLSE +/- thrill (due to flow)
  2. Apical mid-diastolic rumble: relative mitral stenosis
  3. Early diastolic decrescendo murmur of AR (infundibular VSD)
  4. loud P2 (PHTN/Eisenmengers)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

ecg findings of ASD

A

RBBB from RV dilation - not from actual block!

mild RVH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

cxr findings of ASD vs VSD

A

ASD: RA enlargement, inc pulmonary vascular markings
VSD: LAH bc of inc volume return and RAH
- remember in Eisenmenger’s the LAH will improve bc now pul pressure > systemic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

natural hx of ASD

A

<3mm - 100% spontaneously close
3-8mm - 80% by 1-2yo
>8mm - rare spont close

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

preferred way to close an ASD

A

non-surgical via catheter into IVC and expanding device!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

conditions a/w VSD (3)

A

Turner
T21
DiGeorge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

most common type of VSD

A

peri-membranous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

why do we care about a outlet (infundibular or conal) VSD

A

aortic leaflet can prolapse through the VSD and cause aortic insufficiency or RVOT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

which type of VSDs do not close spontaneously? which do?

A

Inlet and outlet (infundibular) VSDs do NOT

muscular > perimembranous DO close

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

ecg findings of VSD

A 
dependent on size of VSD 
small = normal 
Moderate VSD = LVH and occasional LAH 
Large VSD = BVH with or without LAH
If pulmonary obstructive disease = only RVH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

indications for surgical repair of VSD

A

PHTN, shunt >2:1

impact on growth <6mo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

frequent complication of surgical VSD repair

A

RBBB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

when does Eisenmengers tend to happen in a VSD

A

teenage years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

complete vs partial AVSD

A 
complete = VSD + primum ASD + clefts in the mitral and tricuspid valve (single valve orifice, usually 5 leaftlets)
partial = ostium primum type of ASD +  cleft in the mitral valve
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

AVSD basically means what condition?

A

T21 (70% AVSD are T21)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

partial AVSD vs just a primum ASD

A

partial AVSD - MR often trivial, but can have LA / LV enlargement if MR is significant, and CHF can therefore develop earlier

24
Q

when to repair a partial AVSD

A

elective + asymptomatic -> 2-4yo

earlier in FTT, MR, or common atrium

25
Q

how is the shunt of a complete AVSD different from a VSD?

A

it’s an obligatory shunt, determined by size of defect not PVR:
from LV > RA

26
Q

heart sounds of complete AVSD (3)

A
  1. S1 is accentuated – due to abnormal AV valve
  2. S2 narrowly splits
  3. P2 increased in intensity – due to pulmonary HTN
27
Q

classic exam findings for PDA (4)

A

bounding peripheral pulses, wide pulse pressure
hyperactive praecordium
continuous machinery murmur left infraclavicular/LUSE
apical diastolic rumble (mitral flow)

28
Q

Eisenmenger’s in PDA - what is different about the cyanosis

A

LOWER half body cyanosis only

29
Q

natural Hx of PDA in prem vs term

A

prem - PDA can spontaneously close

term - rare

30
Q

what sided hypertrophy with PDA, and why?

A

Increased flow returning to the left heart results in increased left atrial and left ventricular end-diastolic pressures. The left ventricle compensates by increasing stroke volume and eventually may hypertrophy to normalize wall stress.

31
Q

standard approach to fixing a PDA surgically

A

posterolateral thoracotomy

32
Q

peripheral pulmonary stenosis - 3 major causes

A

a. Congenital rubella
b. Alagille syndrome
c. Williams syndrome

33
Q

Peripheral or valvular peripheral stenosis:

  • congenital rubella
  • alagille
  • williams
  • noonan
A

Congenital rubella = BOTH
Alagille = peripheral
Williams = peripheral
Noonan = valvular with dysplastic pulmonary valves

34
Q

murmur:
- PS
- peripheral PS
- AS
- MS
- MR
- AR

A
  • PS: ejection systolic LUSE, click
  • peripheral PS: mid systolic LUSE, axilla and back
  • AS: ejection systolic RUSE, click
  • MS: mid diastolic rumble, apex
  • MR: regurgitant systolic, apex. S3 often present
  • AR: High pitched diastolic decrescendo murmur with water hammer pulse
35
Q

what happens to the vessel post a stenosis

A

dilation

36
Q

ways to treat a PS vs AS

A

PS - PGE infusion - keep PDA open
balloon valvuloplasty - treatment choice for all ages
surgery - valve replacement

AS - keep PDA open, no competitive sport in severe AS
balloon valvuloplasty not as effective
surgical more common, less time to re-intervention

37
Q

what does an ejection click mean on auscultation?

mid systolic click?

A

ejection: valvular stenosis of some kind!

mid systolic: MVP!!

38
Q

types of AS

A

1) valvular (70%) - bicuspid v common
2) subvalvular (25%) - 2/3 have associated cardiac lesions
3) supravalvular (5%) - annular constriction at valsalva sinus

39
Q

two conditions associated with supravalvular AS

A
  1. William syndrome

2. Familial hypercholesterolaemia

40
Q

classic triad of AS presentation

A
  1. dyspnoea
  2. chest pain
  3. exertional syncope
41
Q

signs of critical AS in a neonate

A

reduced peripheral perfusion (weak and thread pulse, pale cool skin, slow cap refill - from ductus closing

42
Q

what other aortic conditions can result from AS?

A

post stenotic aortic dilatation

AR

43
Q

what is the main surgery we use for AS?

A

Ross operation: patient’s own pulmonary valve replaces their shitty aortic one
then a homograft replaces the pulmonary valve- lasts longer as lower pressures, but will eventually need replacement

44
Q

coarct - think what syndromic condition

A

Turners

45
Q

coarct - think what associated defects

A

bicuspid aortic in 50-80%

berry aneurysm

46
Q

CXR findings of coarct

A

1) rib notching between 4th-8th ribs in >8yo with large collateratls
2) post stenotic dilatation of aorta

47
Q

ways a coarct can present

A

1) well neonate - differential cyanosis, absent femoral pulses
2) unwell neonate - shock in first 6 weeks, absent femoral pulses
3) older child - HTN (UL>LL), murmur

48
Q

complications post coarct repair

A

coarct repair either - end to end anastamosis, subclavian flap, balloon

re-stenosis
aneurysm
HTN

49
Q

what syndrome must always be thought of with interrupted aortic arch

A

DiGeorge - need to do workup e.g. Ca

50
Q

what arrhythmia can result from MS

A

AF

51
Q

most common valvular involvement in children with rheumatic heart disease

A

MR

52
Q

causes of MR in children

A
  1. rheumatic fever

2. associated with AVSDs

53
Q

MVP - a/w what syndromes

A

CT diseases: Marfan, EDS, osteogenesis imperfecta, Stickler syndrome, PCKD (adults)

54
Q

MVP most commonly associated with what other cardiac defect

A

secundum ASD

55
Q

what can cause an AR?

A

bicuspid aortic valve

dilated aortic root e.g. marfans, EDS

56
Q

what is cor triatrium

A

Atrium divided into 3 parts by fibromuscular septum (usually two on left) –> like MS

cardiology (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions