Cardiac Defects Flashcards
Normal pressure curve but reduced overall with increased atrial pressure (but overall increased)
Mitral stenosis
aortic pressure curve follows decreased trajectory (similar pattern but less extreme and lower over all) ejection happens with greater velocity
aortic stenosis
Normal ventricular and atrial pressure curve but aortic pressure curve drops sharply after ejection
Aortic regurgitation
Decreased overall pressure curve, left atrial pressure spikes in systole
Mitral regurgitation
Murmurs that enhance on inspiration
- originate from right heart
- increased venous return delay pulmonic valve closure and increase tricuspid regurgitation
Murmurs that increase upon expiration
- increase mitral or aortic regurgitation (prolonging systole increases ventricular filling?)
Aortic valve closure -> pulmonic valve closure -> opening snap -> long decrescendo -> short crescendo -> S1
Splitting of the second sound in mitral stenosis
- mitral stenosis causes opening snap due to blood rushing in at higher velocity and hitting the residual volume in ventricle
Delay between aortic and pulmonic valve closure
- accentuated during inspiration
- may be seen in expiration due to right bundle branch block
Pulmonic valve closing before the aortic typically heard on expiration
- delayed LV systole (left AV brand block)
- prolonged left ventricular systole (aortic stenosis, severe HTN, left sided HF)
- early right ventricular systole (WPW syndrome)
Murmurs that increase on inspiration
- originate from rt heart
- decrease in intrathroacic pressure increases venous return delaying polmonic valve closure widening split
Crescendo-decrescendo systolic murmur
Aortic stenosis
Late crescendo systolic murmur
Mitral prolapse
HR of 30-40 BPM
- purkinje fiber overdrive suppression
- in this case won’t normally see atrial depol
HR of 40-60 BPM
AV node overdrive suppression
Mid systolic click
- mitral valve prolapse: myxoid degeneration
Crescendo-decrescendo: pan systolic murmur
- aortic stenosis
- may be associated with rheumatic heart disease (commissure fusion)
- most commonly assoc with age wear and tear (no commissural fusion)
Eisenmenger syndrome
- left to right shunting
- result of large VSD
- usually silent at birth-> eventually flow reverses and you end up with lower ext cyanosis
Most common ASD
- osteum secondum
- osteum primum: associated with downs
ASD assoc. with Down syndrome
- Ostium primum ASD
Babies who develop cyanosis early in life, boot shaped heart on X-ray
- ToF
- right to left shunts
- patients may end up squatting to alleviate symptoms
Condition resulting in right to left shunting (early cyanosis) assoc with maternal diabetes
- transposition of great vessels
- trt with PGE to keep DA open
Truncus arteriosis
- common outflow tract
- ## DO2/O2 blood mixing -> early cyanosis
Coarctation of the aorta: two forms
- lower extremity cyanosis
- associated with Turner syndrome
- adult form HTN in UEX, weak pulses and LEX in LUX
Weak peripheral pulses and orthostasis
- aortic stenosis
Classic finding of ASD
Promenet right ventricular impulse, systolic ejection murmur, and fixed splitting of S1
Additionally generally present in truncus arteriosis
- VSD
Sinus Venarium
- smooth part of r atria
- derived from sinus venosus
Newborn with high arched palpate, broad chest, widely spaced nipples, pedal edema
- coarctation of the aorta
Embryology of osteium primum defect
- septum primum fails to fuse with endocaridal cushions
Congenital defect assoc with rubella
- PDA