Cardiac issues Flashcards
What are the 2 things that exist in foetal circulation but not in normal circulation?
Foramen Ovale
Ductus arteriosus
What is the foramen ovale?
Patent foramen ovale (PFO) is a hole between the left and right atria (upper chambers) of the heart. This hole exists in everyone before birth, but most often closes shortly after being born. PFO is what the hole is called when it fails to close naturally after a baby is born.
What is the ductus arteriosus?
ductus arteriosus is a blood vessel that connects the pulmonary artery (main vessel supplying the blood to the lungs) to the aorta (main vessel supplying the blood to the body). This connection is present in all babies in the womb, but should close shortly after birth.
Why are the FO and DA important in a clinical context?
Foramen Ovale and Ductus Arteriosis can remain patent beyond initial neonatal period
In duct dependent lesions, this can assist survival
Explains why some lesions may not become apparent until a few weeks of age
What are the 3 broad categories of congenital heart disease?
Holes/connections
Narrowings
Complex
What happens in atrial septal defect?
Opening between atria
What are the clinical features of atrial septal defect?
Asymptomatic when younger
Fixed and widely split S 2
Ejection Systolic murmur in pulmonary area
Older children and adults get signs and symptoms: Fixed splitting ,ESM,Palpitations
What are the types of atrial septal defect?
Ostium Secundum
Ostium Primum
Sinus Venosus ASD
What is patent ductus arteriosus?
When there is a vessel connecting aorta and the pulmonary artery
What are the clinical features of patent ductus arteriosus?
Usually preterm babies
Poor feeding, failure to thrive tachypnoea
Active precordium,Thrill, Gallop rhythm
Classical continuous machinery murmur pulmonary area
Hepatomegaly,oedema
What happens in a ventricular septal defect?
Even large VSD’s may not present symptomatically until PVR has fallen
Poor feeding ,failure to thrive ,tachypnoea
Active precordium,Thrill ,Gallop rhythm
Pan systolic murmur best heard in LLSE transmits to upper sternal edge and axillae
Hepatomegaly ,oedema
What happens in an atrioventricular septal defect?
Theres an opening between ventricles
Underdeveloped leaflet of mitral and tricuspid valve
Clinical features of Atrioventricular septal defect
Common defect in Trisomy 21
Can lead more rapidly to Pulmonary Vascular disease so important to screen all children with down’s syndrome with Echocardiograms
Poor feeding ,failure to thrive, tachypnoea
Active precordium ,Thrill ,Gallop rhythm
Hepatomegaly ,oedema
Murmur arises from the valvular regurgitation rather than septal defects
What are the types of stenoses/ Narrowings?
Coarctation of the Aorta
Aortic Stenosis
Pulmonary Stenosis
What happens in coarctation of the aorta?
Narrowed aorta
Clinical features of coarctation of the aorta?
Weak femoral pulses
Always compare to brachials
Pre and post ductal difference in saturations(but only if duct open)
4 limb BP: Discrepancy between upper limb and lower limb blood pressure
Older children murmur over back (after collaterals develop)
If duct has closed/ is closing these babies present collapsed and acidotic
What happens in aortic stenosis?
There is a thickened, narrow aortic valve
What are the clinical features of an aortic stenosis?
Weak Pulses
Thrill palpable in suprasternal region and carotid area
Ejection systolic murmur in aortic area
If critical aortic stenosis then child presents collapsed and acidotic
What happens in pulmonary stenosis?
Thickened pulmonary valve
What happens in pulmonary stenosis
Ejection systolic Murmur in the Left Upper sternal edge
Murmur often radiates to the back especially if the pulmonary branches are also stenosed
Right Ventricular heave (if significant stenosis)
What are some Common cyanotic heart conditions?
Transposition of the Great Arteries
Tetralogy of Fallot’s
What happens in transposition of the great arteries?
There is an opening between atria
The vessels (aorta and pulmonary artery) are switched
VESSEL CONNECTING AORTA AND PULMONARY ARTERY
What are the clinical features of transposition of the great arteries?
Depending on lesion,severity,age etc
Cyanosis
Acidosis
Collapse/ Death
What happens in TOF
Look back at 2nd year notes
Clinical features of TOF
Depending on lesion,severity,age etc
Cyanosis
Collapse
Acidosis
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