Cardio path2

Question 1

Eisenmenger’s syndrome

Answer 1

Uncorrected VSD, ASD, PDA causes compensatory pulm vascular hypertrophy, which results in progressive pulm HTN.

As pulm resistance goes up, the shunt reverses from L to R to R to L, which causes late cyanosis, clubbing and polycythemia.

Question 2

Tetralogy of Fallot

Answer 2

Caused by anterosuperior displacement of infundibular septum

1) Pulm infundibular stenosis (most important prognosis)
2) RVH
3) Overriding aorta (overrides the VSD)
4) VSD

Question 3

Tetralogy of Fallot: pathogenesis

Answer 3

Pulm stenosis forces R to L flow and causes RVH

on x ray, boot shaped heart

Question 4

Tetralogy of fallot: treatment

Answer 4

Squatting to increase PVR, thus decreasing the cyanotic R to L shunt across the VSD.

Preferred tx: primary surgical correction

Question 5

D-transposition of great vessels

Answer 5

Due to failure of aorticopulmonary septum to spiral

Question 6

Coarctation of the aorta

Answer 6

Can result in aortic regurg,
Infantile: proximal to ductus arteriosus (preductal), Turners
Adult: postductal, associated with bicuspid aortic valve, notching of ribs, HTN in upper extremities, weak pulses and lower extremities.

Question 7

Patent ductus arteriousus

Answer 7

Uncorrected PDA can eventually results in late cyanosis in the lower extremities (differential cyanosis)