cardiac anomalies Flashcards
cardiac anomalies are the most common type of fetal anomaly
true/false
true
what are the maternal risk factors?
maternal cardiac defects
metabolic disorders
what are the common types of metabolic disorders?
insulin dependent diabetics (type 1)
phenylketonuria (PKU)
teratogen exposure
-litium, alcohol, anticonvulsants
what are some fetal risk factors?
fetal arrhythmia extracardiac anomaly chromosomal abnormalities structural abnormality nonimmune hydrops polyhydramnios increased nuchal translucency twin gestation
what are some familial risk factors?
previously affected child paternal/maternal heart disease mendelian syndromes - tuberous sclerosis - noonan syndrome - holt-oram syndrome - ellis van creveld syndrome
what are the different types of beart abnormalities?
- atrial septum defects
- ventricular septal defects (VSD)
- atrioventricular septal defects (AVSD)
- transposition of great arteries (TGA)
- truncus arteriosus
- double outlet right ventricle
- tetralogy of fallot (TOF)
- ebstein anomaly
- hypoplastic ventricle
- rhabdomyoma
- anomalous pulmonary venous connection
- heterotaxy
- ectopic cordis
what are the 3 types if atrial septal defects?
secundum
sinus venosus
primum
what atrial septal defect in the most common?
a. sinus venosus
b. secundum
c. inlet
d. primum
b. secundum
where would a sinus venosus defect be located?
posterior to the foramen ovale
where would a primum defect be located?
immediately above the atrioventricular valves
what are the different types of ventricular septal defects (VSD)?
perimembranous VSDs
muscular VSDs
inlet defect
what is the best way to detect a ventricular septal defect?
color doppler
what else can an atrioventricular septal defect (AVSD) be referred to as?
endocardial cushion defect
AV canal defect
where is the atrioventricular septal defect located?
in the central part of the heart
what are some other anomalies associated with AVSD?
- tetralogy of fallot
- double outlet right ventricle
- coarctation of the aorta
- subaortic stenosis
- ventricular hypoplasia
- pulmonary valve stenosis
what is the transposition of great arteries (TGA)?
the aorta arises from the right ventricle & the pulmonary artery arises from the left ventricle.
what are some associated anomalies with TGA?
patent ductus arteriosus
patent foramen ovale
ventricular septal defect
what is the sonographic appearance of TGA?
4CH view will appear normal ; 2 great vessels do NOT criss cross but arise PARALLEL from the base of the heart.
what is truncus arteriosus?
single arterial vessel that arises from the base of the heart & typically overrides the ventricular system, involving both systemic & pulmonary circulation
what is the sonographic appearance of truncus arteriosus?
- 4CH view will appear normal
- truncal root overrides
- pulmonary arteries must be seen to differentiate
- can mimic tetralogy of fallot w/ pulmonary atresia
what does FISH stand for?
fluorescent in situ hybridization ; analysis for chromosome 22q11 detection
FISH is not associated with truncus arteriosus
true/false
false; it is
what is double outlet right ventricle?
both great arteries arise from he morphologic right ventricle; the arrangement of the great arteries may vary: normal, inverted, transposed or side by side.
what other cardiac anommalies are associated with double outlet right ventricle?
- hypoplastic left ventricle
- atrioventricular valve abnormalities
- VSDs
- single ventricle anatomy with both great arteries arising from a small right ventricle
what is the sonographic appearance of DORV?
- deviation of axis of frequently seen
* can be difficult to distinguish DORV from a large VSD, TOF & TGA
tetralogy of fallot (TOF) is the least common form of cyanotic heart disease
true/false
false; most common
what are the specific defects associated with TOF?
- subaortic ventricular septal defect
- aortic valve overriding the defect
- pulmonic stenosis
- hypertrophy of the right ventricle
what is the sonographic appearance of TOF?
- 4CH can appear normal
- ventricular septal defect
- increase rotation of the heart
- orverriding aorta
- ascending aorta will appear larger than pulmonary artery
what is ebstein anonaly?
displacement of the septal & posterior leaflets of the tricuspid valve into the right ventricle
what is the sonographic appearance of ebstein anomaly?
- visualized on 4CH view
- enlargement of the heart, especially the right atrium
- color & spectral doppler will reveal regurgitation across the tricuspid valve
what are the 2 types of hypoplastic ventricle?
left & right
what is left hypoplastic ventricle (LHV)?
near absence of the let ventricle
what does LHV usually occur with?
mitral & aortic atresia
what is right hypoplastic ventricle RHV)?
small RV
what does RHV usually occur with?
pulmonary or tricuspid atresia
what is the sonographic alpearance of RHV?
small RV
usually associated with ASD & VSD
may have pulmonary outflow obstruction
can be associated w/ TGA
what is the most common intracardiac tumor?
rhabdomyoma
what percentage of rhabdomyomas are singular? multiple?
50% for both
what are multiple rhabdomyomas associated with?
tuberous scerosis
what is the sonographic appearance of a rhabdomyoma?
echogenic mass w/in fetal heart
rhabdomyomas continue to grow postnatally
true/false
false; most regress postnatally, either partially or completely
what is an arrythmia?
abnormal heart rhythm
what is the heart rate range for supraventricular tachycardia?
220-260 bpm
what is the heart rate range for sinus tachycardia?
180-200 bpm
what is the range for brachycardia?
less than 100 bpm
what is the range for atrial flutter?
greater than 300 bpm
what are some extracardiac things that can cause brachycardia?
head or cord compression
hypoxia
maternal drugs
how are arrythmias treated?
medications (heart blocks)
steroids
what is anomalous pulmonary venous connection?
an abnormal connection b/w one or more of the pulmonary veins & the atria
instead of all pulmonary veins connecting to the left atrium, some connect to the right atrium
how many pulmonary veins doe we have?
4, 2 from each lung
what is heterotaxy?
mirrored anatomical arrangement of the organs on the opposite side, particularly in the thorax
what is another name heterotaxy can be referred to as?
cardiosplenic syndromes
what are the 2 types of heterotaxy?
double right sidedness
double left sidedness
what’s another name for double right sidedness?
ivemark syndrome
right isomerism
asplenia syndrome
in a case of double right sidedness, the left lung will be bi-lobe
true/false
false; the left lung with be tri-lobe
what is another name for double left sidedness?
left isomerism
polysplenia
what is ectopic cordis?
all or part of the heart is located outside of the chest cavity
what is associated with ectopic cordis?
intracardiac anomalies
omphalocele
what is the sonographic appearance of ectopic cordis?
- small thorax
* extension of soft tissue outside thoracic cavity in which cardiac cavity is present
what does pentalogy of cantrell consist of?
ectopia cordis diaphragmatic defect omphalocele or ventral ABD wall defect pericardial defect intracardiac malformation
