Cardio Path Flashcards
Right to Left Shunts?
Early cyanosis: 5 T’s
1 Truncus arteriosus (1 vessel)
2 Transposition of vessels (2 switched vessels)
3 Tricuspid atresia (3=tri, must have ASD and VSD to be viable)
4. TETRAlogy of Fallot
5. Total Anomoalous Pulmonary venous return (pulm beans drain to right heart. Need ASD or PDA to have R-L shunt and maintain CO
Boot shaped heart?
Tetralogy of Fallot (RVH causes it). Also has Pulmonary stenosis (IMPORTANT FOR PROGNOSIS), over riding aorta and VSD. IT is most comma ncause of childhood cyanosis
Most common L to R shunts?
VSD>ASD>PDA
Wide fixed S2 split?
ASD (regardless of breath, the pressure equalized R-L so there is a fixed split)
Differential cyanosis happens with what?
PDA b/c shunt is after first branches after aorta and blood goes back to R side
What are signs of Eisenmenger syndrome and what is it caused by?
Uncorrected L-R causes high pulmonary flow and remodeling of pulm vasculature causes pulmonary HTN and RVH compensates and shunt becomes R to L L. See late cyanosis, clubbing and polychythemia (makes sense to make more RBC when low O2)
Rib notching?
adult coarctation
Difference between adult and infant coarctation?
Infant is proximal to PDA and presents with closure of ductus arterioles, reopen it with PGE2. Adult type is distal to the aortic arch
Other heart issues associated with coarctation?
Turner syndrome (X0) and bicuspid aortic valve
Congenital heart condition associated with: 22q11 syndrome?
Truncus arteriosus, Tetralogy of Fallot (makes sense, failure of neural crest cells to migrate to make a proper separation of great arteries)
Congenital heart condition associated with: Down syndrome
Down syndrome? Endocardial cusion defects: (especially know ASD) ASD, VSD, AV septal defect
Congenital heart condition associated with: Fetal Alcohol Syndrome?
VSD
Congenital heart condition associated with: Turner Syndrome
Bicuspid aortic valve and coarctation
Congenital heart condition associated with: Marfan syndrome?
MVP and dissection resulting in aortic regurgitation
Congenital heart condition associated with: diabetic mother?
Transposition of Great Arteries (TGa1c (like HbA1c, but just say TGa1c!)
Congenital heart condition associated with: Congenital rubella
PDA!! Septal defects, pulmonary artery stenosis
Congenital heart condition associated with: mother on Lithium (came up in Q bank)
Ebstein abnormality: Downwardly displaced tricuspid with large right atria dysfunction right ventricle
Renal artery stenosis causes secondary hypertension, what can cause the stenosis?
- If old: atherosclerosis.
2. If young female, fibromuscular dysplasia (string of beads appearance on angiogram pg 284 of FA 2014)
Calcificaiton of media of arteries are what?
Monckeberg medial calcific sclerosis. DOES NOT OBSTRUCT FLOW and is benign finding and looks like a pipestem on x ray
2 types of arteriolosclerosis
small vessels:
- Hyaline: from diabetes (non enzymatic glycosylation or benign HTN pushing proteins into vessel wall) and walls look thick and pink.
- Hyperplastic: onion skinning from malignant HTN
Atherosclerosis complications (note the first as being interesting)
Aneurysm, ischemia, infarct, pvd, thrombus and emboli.
Symptoms: angina and claudication
Risk factor for abdominal aortic aneurism:
Smoking and more than 50 years old
3 causes of thoracic aortic aneurism
- Cystic medial degeneration from HTN
- Marfan (younger patients)
- Tertiary syphilis form OBLITERATIVE ENDARTERITIS of vasa vasorum (less blood flow to wall of blood vessel so it becomes weaker)
unequal BP in arms
Aortic dissection
