Cardio13 Flashcards
Congenital Heart disease
What congenital heart condition causes Early cyanosis (“blue-babies”)?
Late cyanosis (“blue-kids”)?
Early = Right-to-Left shunts
Late = Left-to-Right shunts
What are the Right-to-Left shunts?
Tetralogy of fallot Transposition of great vessels Persistent Truncus arteriosus Tricuspid atresia Total anomalous pulmonary venous return
“the 5 Ts”
What are the Left-to-Right shunts?
Ventricular Septal Defect (VSD)
Atrial Septal Defect (ASD)
Patent Ductus Arteriosus (PDA)
What is the most common cause of Early cyanosis?
Tetralogy of Fallot
What is the most common congenital cardiac anomaly?
VSD
What is the frequency of the Left-to-Right shunts?
VSD > ASD > PDA
What syndrome is caused by uncorrected VSD, ASD, or PDA?
Eisenmenger’s syndrome
What does uncorrected VSD, ASD, or PDA cause?
Compensatory pumonary vascular Hypertrophy, which results in Progressive Pulmonary Hypertension
What happens in Eisenmenger’s syndrome as Pulmonary Resistance INcreases?
Shunt reverses from left-to-right to right-to-left
Causes:
- Late cyanosis
- Clubbing
- Polycythemia
What causes Tetralogy of Fallot?
Anterosuperior displacement of the Infundibular Septum
What are the 4 parts of tetralogy of Fallot?
“PROVe”
Pulmonary infundibular stenosis
Right Ventricle Hypertrophy
Overriding Aorta
Ventricular Septal Defect
What is the preferred treatment for tetralogy of Fallot?
early, primary surgical correction
Why does squatting relieve cyanotic symptoms in older Fallot’s patients?
Reduces blood flow to the legs
INcreases PVR
DEcreases the cyanotic right-to-left shunt across the VSD
What is D-transporsition due to?
Failure of the aorticopulmonary septum to spiral.
Aorta leaves RV (anterior) and Pulmonary trunk leaves LV (posterior) –> Seperation of systemic and pulmonary circulations
Infantile type Coarctation of the Aorta.
Aortic Stenosis proximal to insertion of Ductus Arteriosus (preductal)
“INfantile: IN close to the heart”
What syndrome is Infantile type Coarctation of the Aorta associated with?
Turner syndrome
Adult type Coarctation of the Aorta.
Stenosis is Distal to Ligamentum Arteriosum (Postductal)
“aDult: Distal to Ductus”
What is Adult type Coarctation of the Aorta most commonly associated with?
Bicuspid Aortic Valve
Describe Patent Ductus Arteriosus in fetal and neonatal stages.
In fetal period, shunt is normal (right-to-left)
Neonatal, Lung resistance DEcreases and shunt becomes left-to-right w/subsequent RVH and/or LVH and failure
Patency of the ductus arteriosus is maintained by what?
PGE synthesis
Low O2 tension
What medication closes the patent duct?
Endomethacin Ends patency of PDA
*PGE; kEEps it open
When would you want to keep the ductus arteriosus patent?
Transposition of the great vessels
treat with PGE
What is the murmur heard in PDA?
continous, machine-like murmur
Congenital cardiac defect associations:
22q11 syndromes
Truncus Arteriosus
Tetralogy of Fallot
