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OB/GYN pathology > cardiac anomalies > Flashcards

cardiac anomalies Flashcards

1
Q

cardiac anomalies are the most common type of fetal anomaly

true/false

A

true

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2
Q

what are the maternal risk factors?

A

maternal cardiac defects

metabolic disorders

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3
Q

what are the common types of metabolic disorders?

A

insulin dependent diabetics (type 1)
phenylketonuria (PKU)
teratogen exposure
-litium, alcohol, anticonvulsants

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4
Q

what are some fetal risk factors?

A 
fetal arrhythmia
extracardiac anomaly
chromosomal abnormalities
structural abnormality
nonimmune hydrops
polyhydramnios
increased nuchal translucency
twin gestation
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5
Q

what are some familial risk factors?

A 
previously affected child
paternal/maternal heart disease
mendelian syndromes
- tuberous sclerosis
- noonan syndrome
- holt-oram syndrome
- ellis van creveld syndrome
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6
Q

what are the different types of beart abnormalities?

A
  • 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
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7
Q

what are the 3 types if atrial septal defects?

A

secundum
sinus venosus
primum

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8
Q

what atrial septal defect in the most common?

a. sinus venosus
b. secundum
c. inlet
d. primum

A

b. secundum

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9
Q

where would a sinus venosus defect be located?

A

posterior to the foramen ovale

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10
Q

where would a primum defect be located?

A

immediately above the atrioventricular valves

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11
Q

what are the different types of ventricular septal defects (VSD)?

A

perimembranous VSDs
muscular VSDs
inlet defect

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12
Q

what is the best way to detect a ventricular septal defect?

A

color doppler

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13
Q

what else can an atrioventricular septal defect (AVSD) be referred to as?

A

endocardial cushion defect

AV canal defect

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14
Q

where is the atrioventricular septal defect located?

A

in the central part of the heart

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15
Q

what are some other anomalies associated with AVSD?

A
  • tetralogy of fallot
  • double outlet right ventricle
  • coarctation of the aorta
  • subaortic stenosis
  • ventricular hypoplasia
  • pulmonary valve stenosis
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16
Q

what is the transposition of great arteries (TGA)?

A

the aorta arises from the right ventricle & the pulmonary artery arises from the left ventricle.

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17
Q

what are some associated anomalies with TGA?

A

patent ductus arteriosus
patent foramen ovale
ventricular septal defect

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18
Q

what is the sonographic appearance of TGA?

A

4CH view will appear normal ; 2 great vessels do NOT criss cross but arise PARALLEL from the base of the heart.

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19
Q

what is truncus arteriosus?

A

single arterial vessel that arises from the base of the heart & typically overrides the ventricular system, involving both systemic & pulmonary circulation

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20
Q

what is the sonographic appearance of truncus arteriosus?

A
  • 4CH view will appear normal
  • truncal root overrides
  • pulmonary arteries must be seen to differentiate
  • can mimic tetralogy of fallot w/ pulmonary atresia
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21
Q

what does FISH stand for?

A

fluorescent in situ hybridization ; analysis for chromosome 22q11 detection

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22
Q

FISH is not associated with truncus arteriosus

true/false

A

false; it is

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23
Q

what is double outlet right ventricle?

A

both great arteries arise from he morphologic right ventricle; the arrangement of the great arteries may vary: normal, inverted, transposed or side by side.

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24
Q

what other cardiac anommalies are associated with double outlet right ventricle?

A
  • hypoplastic left ventricle
  • atrioventricular valve abnormalities
  • VSDs
  • single ventricle anatomy with both great arteries arising from a small right ventricle
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25
Q

what is the sonographic appearance of DORV?

A
  • deviation of axis of frequently seen

* can be difficult to distinguish DORV from a large VSD, TOF & TGA

26
Q

tetralogy of fallot (TOF) is the least common form of cyanotic heart disease
true/false

A

false; most common

27
Q

what are the specific defects associated with TOF?

A
  • subaortic ventricular septal defect
  • aortic valve overriding the defect
  • pulmonic stenosis
  • hypertrophy of the right ventricle
28
Q

what is the sonographic appearance of TOF?

A
  • 4CH can appear normal
  • ventricular septal defect
  • increase rotation of the heart
  • orverriding aorta
  • ascending aorta will appear larger than pulmonary artery
29
Q

what is ebstein anonaly?

A

displacement of the septal & posterior leaflets of the tricuspid valve into the right ventricle

30
Q

what is the sonographic appearance of ebstein anomaly?

A
  • visualized on 4CH view
  • enlargement of the heart, especially the right atrium
  • color & spectral doppler will reveal regurgitation across the tricuspid valve
31
Q

what are the 2 types of hypoplastic ventricle?

A

left & right

32
Q

what is left hypoplastic ventricle (LHV)?

A

near absence of the let ventricle

33
Q

what does LHV usually occur with?

A

mitral & aortic atresia

34
Q

what is right hypoplastic ventricle RHV)?

A

small RV

35
Q

what does RHV usually occur with?

A

pulmonary or tricuspid atresia

36
Q

what is the sonographic alpearance of RHV?

A

small RV
usually associated with ASD & VSD
may have pulmonary outflow obstruction
can be associated w/ TGA

37
Q

what is the most common intracardiac tumor?

A

rhabdomyoma

38
Q

what percentage of rhabdomyomas are singular? multiple?

A

50% for both

39
Q

what are multiple rhabdomyomas associated with?

A

tuberous scerosis

40
Q

what is the sonographic appearance of a rhabdomyoma?

A

echogenic mass w/in fetal heart

41
Q

rhabdomyomas continue to grow postnatally

true/false

A

false; most regress postnatally, either partially or completely

42
Q

what is an arrythmia?

A

abnormal heart rhythm

43
Q

what is the heart rate range for supraventricular tachycardia?

A

220-260 bpm

44
Q

what is the heart rate range for sinus tachycardia?

A

180-200 bpm

45
Q

what is the range for brachycardia?

A

less than 100 bpm

46
Q

what is the range for atrial flutter?

A

greater than 300 bpm

47
Q

what are some extracardiac things that can cause brachycardia?

A

head or cord compression
hypoxia
maternal drugs

48
Q

how are arrythmias treated?

A

medications (heart blocks)

steroids

49
Q

what is anomalous pulmonary venous connection?

A

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

50
Q

how many pulmonary veins doe we have?

A

4, 2 from each lung

51
Q

what is heterotaxy?

A

mirrored anatomical arrangement of the organs on the opposite side, particularly in the thorax

52
Q

what is another name heterotaxy can be referred to as?

A

cardiosplenic syndromes

53
Q

what are the 2 types of heterotaxy?

A

double right sidedness

double left sidedness

54
Q

what’s another name for double right sidedness?

A

ivemark syndrome
right isomerism
asplenia syndrome

55
Q

in a case of double right sidedness, the left lung will be bi-lobe
true/false

A

false; the left lung with be tri-lobe

56
Q

what is another name for double left sidedness?

A

left isomerism

polysplenia

57
Q

what is ectopic cordis?

A

all or part of the heart is located outside of the chest cavity

58
Q

what is associated with ectopic cordis?

A

intracardiac anomalies

omphalocele

59
Q

what is the sonographic appearance of ectopic cordis?

A
  • small thorax

* extension of soft tissue outside thoracic cavity in which cardiac cavity is present

60
Q

what does pentalogy of cantrell consist of?

A 
ectopia cordis
diaphragmatic defect
omphalocele or ventral ABD wall defect
pericardial defect
intracardiac malformation

OB/GYN pathology (7 decks)

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