Cardio

Question 1

Name congenital heart dz with RIGHT TO LEFT SHUNTS

Answer 1

5 T's:
Truncus arteriosis (1 vessel)
Transposition (2 switched vessels)
Tricuspid atresia (3= tri)
Tetralogy of Fallot (4= tetra)
TAPVR (5 letters in name)

Question 2

These babies usually called “blue babies” often diagnosed prenatally or become evident immediately after birth.

Answer 2

early cyanosis. RIGHT TO LEFT SHUNT congenital heart dz

Question 3

Describe truncus arteriosis

Answer 3

failure of truncus arteriosis to divide into pulmonary trunk and aorta

Question 4

Describe transposition of vessels

Answer 4

Aorta leaves RV and pulmonary truck leaves LV–> separation of systemic and pulmonary circulations. Not compatible with life unless a shunt is present to allow mixing of blood. Due to failure of aorticpulmonary septum spiral. usually infants die without surgery.

Create 2 separate circuits instead of one big one. Vessels on the Right never get oxygenated and vessels of the Left never get deoxygenated.

Question 5

Describe tricuspid atresia

Answer 5

absence of tricuspid valve and hypoplastic RV; requires both ASD and VSD for viability.

Question 6

descibe tetralogy of fallot

Answer 6

caused by anterosuperior displacement of the infundibular septum. MOST COMMON cause of early childhood cyanosis. 1. pulmonary infundibular stenosis (most important for prognosis). 2. RVH (boot shaped), 3 Overriding aorta 4. VSD

Question 7

TAPVR “Total anomalous pulmonary venous return”

Answer 7

pulmonary veins drain into right heart circulation. associated with ASD and sometimes PDA.

Question 8

NAme congenital heart dzs with LEFT TO RIGHT SHUNTS

Answer 8

frequency: VSD> ASD> PDA

Question 9

classified as late cyanosis “blue kids”

Answer 9

LEFT TO RIGHT shunt congenital ht dz

Question 10

VSD

Answer 10

most common congenital heart defect. Asymptomatic at birth or late into life.

Question 11

ASD

Answer 11

atrial septal defect. defect in interatrial septum; LOUD S1; wide fixed split S2. distinct from patent foramen ovale in that septa are missing tissue rather than unfused.

Question 12

PDA

Answer 12

in fetal period right to left shunt (which is normal)”machine like” murmur. INDOMETHACIN –>close good. PGE–> keeps open–> both good and bad.

Question 13

describe Eisenmenger syndrome

Answer 13

uncorrected L to R shunt. “party room 1 & 2” with a VSD you get a mixing of oxygenated and non oxygenated blood going through pulmonary artery (with higher pressure in LV compared to RV creating L-R shunt) where it can get congested and lead to pulmonary blood flow congestion–> pulmonary arteriolar HTN and back flow into the RV –> RVH occurs to compensate–> and bc now pressure is higher in RV compared to LV, blood will go R-L shunt. overall leads to DECREASE O2–> DECREASE fxn. Late cyanosis, clubbing, polycythemia (increase in RBC causing congestion and increased pressure and leads to CLUBBING).

Question 14

Left Heart Failure: is it forward or backward failure? Significant symptoms?

Answer 14

Forward bc you are having problems getting blood outside of heart. Symptoms= SOB, hemorrhage and alveolar macrophages will phagocytize RBC leading to rusty colored sputum.

Question 15

Right Heart Failure: Forward or backward failure? Symptoms. Tx

Answer 15

Backward because can’t get blood into heart. Symptoms: neck vein distension, pitting edema, hepatomegaly, nutmeg liver, ascites. Tx: ACE inhibitor bc decreases afterload AND preload at the same time

Question 16

Describe paroxysmal nocturnal dyspnea? Pillow orthopnea? When do you see this?

Answer 16

In HF you are defying gravity by lying down during sleep and the heart struggles even more to pump blood out of heart so gets stuck in the lungs leading to dyspnea for 30 min. When pt uses pillow to sit themselves up to favor gravity called pillow orthopnea. See this in LHF

Question 17

Components of cardiac tamponade

Answer 17

Becks Triad:

1. Hypotension
2. Increase in jugular venous pressure
3. Muffled heart sounds

Question 18

Describe Pulsus Paradoxus

Answer 18

Exaggerated decrease in systolic pressure during inspiration.

Seen in Cardiac tamponade, severe asthma, COPD, hypovolumic shock, constrictive pericarditis.