Cardiac

Question 1

Name temporary structures fetal circulation?

Answer 1

Ductus venosus: shunts a portion of the left umbilical vein blood flow directly to the inferior vena cava, thus most blood bypasses the liver

Ductus arteriosus: connection between the pulmonary artery and the aorta

Foramen ovale: shunt between left and right atrium

Question 2

What are the fetal structures called after birth?

Answer 2

Foramen ovale: fossa ovalis
Ductus venosus: Ligamentum venosum
Ductus arteriosus: Ligamentum arteriosum
Umbilical vein: Ligamentem teres

Question 3

Describe fetal circulation

Answer 3

Placeneta- umbilical vein-ductus venosus-inferior vena cava-right atrium, one pathway: pulmonary trunk- ductus arteriosus- aorta- systemic circulation.
Other pathway from right atrium: foramen ovale-left atrium- left ventricle- aorta

Question 4

Describe ductus arteriosus?

Answer 4

Failure of ductus to close within 1-2 days. Allows blood to flow between the aorta and the pulmonary artery, leading to an increase in flow in the lung circulation. If the PDA is large the pressure in the lungs may also be elevated. Affected babies may develop heart failure in the early weeks of life.

Children with a small PDA are often asymptomatic, but may develop Infective Endocarditis.

Question 5

Treatment for Ductus Arteriosus?

Answer 5

wait for spontaneous closure
Paracetamol or ibuprofen for preterm- inhibit prostaglandin
Prostaglandin E1 may be administered to keep open for surgery

Question 6

What are the cyanotic heart defects?

Answer 6

Cyanotic:

• Transposition of great arteries
• Tetralogy of fallot
• Ebstein’s anomaly

Question 7

What are the acyanoitc heart defects?

Answer 7

• Pulmonary stenosis
• ASD, VSD
• PDA
• Aortic stenosis
• Artrioventricular canal
• Coarcatation of aorta

Question 8

What is hypoplastic left heart syndrome?

Answer 8

congenital heart defect in which the left side of the heart is severely underdeveloped. It may affect the left ventricle, aorta, aortic valve, or mitral valve. Affected infants usually become severely symptomatic soon after birth (as the ductus closes).

Question 9

Prognosis and treatment for hypoplastic left heart syndrome?

Answer 9

This is one of the most serious cardiac malformations and leads to death in the newborn period in almost all affected babies, unless surgery or Heart Transplantation can be offered. Surgery survival 65-70%

Question 10

What is transposition of great arteries and what is management?

Answer 10

Congenital heart defect in which the aorta is connected to the right ventricle, and the pulmonary artery is connected to the left ventricle. Two separate circuits are formed — one that circulates oxygen-poor blood from the body back to the body, and another that recirculates oxygen-rich blood from the lungs back to the lungs. Leads to hypoxia, heart failure and lung damage.

Manage:
Prostaglandin E1- increasing blood flow and improving mixing of oxygen-poor and oxygen-rich blood until surgery can be performed

Question 11

What are the 4 features of Tetralogy of Fallot?

Answer 11

1. Overriding aorta
2. Ventral septal defect
3. Right ventricular hypertrophy
4. Pulmonary stenosis

Question 12

Symptoms of Tetralogy of Fallot?

Answer 12

cyanosis
SOB, tachypnoea
Loss of conciousness
Clubbing of fingers and toes
Poor weight gain
Irritability
'tet spells- toddlers instinctively squat when SOB- increases blood flow to lungs

Question 13

What is total anomalous pulmonary venous return?

Answer 13

congenital malformation in which all four pulmonary veins do not connect normally to the left atrium. Instead the four pulmonary veins drain abnormally to the right atrium by way of an abnormal (anomalous) connection.