Cardiology Flashcards
Most common type of TAPVR
supra cardiac
PV enters into vertical vein, azygous, or SVC
Most common cause of complete vascular ring
DOUBLE aortic arch (40%)
Embryonic cause of double aortic arch
right and left 4th branchial arches
Causes of complete vascular ring
Double aortic arch (40%)
Right aortic arch + PDA/ligementum arteriosus (30%)
Aberrant right subclavian artery (20%)
Anomalous innominate artery (10%)
(rare - aberrant left pulmonary artery)
NO synthesase converts ____ into NO in the _______
Nitric oxide synthase coverts L-ARGININE into nitric oxide in the ENDOTHELIAL CELLS lining the pulmonary blood vessels
Nitric oxide diffuses into ______activates ________, leading to _______ production
Nitric oxide diffuses
into PULMONARY VASCULAR SMOOTH MUSCLE,
activates GUANYL CYCLASE,
leading to cGMP production
Mediators of ductal CONSTRICTION
oxygen
prostaglandin F2
acetylcholine
bradykinin
Mediators of ductal DILATION
PGE -1
PGE - 2
hypoxia
acidosis
Timeline of ductal closure (functional and anatomic)
Term:
functional 48 hrs
anatomic 2-4 wks
Preterm: functional- days to weeks
Reverse differential cyanosis causes
D-TGA + PDA + (one of the following):
- PPHN
- coarctation
- interrupted AA
Most common type of VSD
Perimembranous VSD(70%) can extend into:
- trabecular region (most common)
- inlet (eg AV canal)
- Infudibular region (eg ToF)
Fetal oxygen saturation in the Umbilical vein
*70% - Umbilical Vein
65% - LEFT Atrium, LEFT Ventricle (UV +PV)
65% - PRE-Ductal (to head/upper body)
———
40% SVC (lowest coming from brain)
45% IVC
55% RIGHT Atrium, RIGHT Ventricle
55% Pulm artery, Pulm Vein
60% POST-Ductal (to lower body/placenta)
Fetal oxygen saturation LA/LV
70% - Umbilical Vein
*65% - LEFT Atrium, LEFT Ventricle (UV +PV)
65% - PRE-Ductal (to head/upper body)
———
40% SVC (lowest coming from brain)
45% IVC
55% RIGHT Atrium, RIGHT Ventricle
55% Pulm artery, Pulm Vein
60% POST-Ductal (to lower body/placenta)
Fetal oxygen saturation to head/upper body
70% - Umbilical Vein
65% - LEFT Atrium, LEFT Ventricle (UV +PV)
*65% - PRE-Ductal (to head/upper body)
———
40% SVC (lowest coming from brain)
45% IVC
55% RIGHT Atrium, RIGHT Ventricle
55% Pulm artery, Pulm Vein
60% POST-Ductal (to lower body/placenta)
Fetal oxygen saturation in IVC and SVC
70% - Umbilical Vein
65% - LEFT Atrium, LEFT Ventricle (UV +PV)
65% - PRE-Ductal (to head/upper body)
———
*40% SVC (lowest coming from brain)
*45% IVC
55% RIGHT Atrium, RIGHT Ventricle
55% Pulm artery, Pulm Vein
60% POST-Ductal (to lower body/placenta)
Fetal oxygen saturation in RA/RV
70% - Umbilical Vein
65% - LEFT Atrium, LEFT Ventricle (UV +PV)
65% - PRE-Ductal (to head/upper body)
———
40% SVC (lowest coming from brain)
45% IVC
*55% RIGHT Atrium, RIGHT Ventricle
55% Pulm artery, Pulm Vein
60% POST-Ductal (to lower body/placenta)
Blood flow to lungs
2nd trimester
3rd trimester
>38 weeks gestation
2T - 7-15%
3T - ~35% (pulmonary vessel growth)
>38w - 20% (pulmonary vessels become sensitive to hyperemic environment and constrict)
Percentage of fetal blood flow to the placenta
45%
Percentage of fetal blood flow that crosses the PDA
60%
Percentage of total fetal blood flow from RV and LV
RV - 66%
LV - 34%
Head/upper body ~20%
Lower body ~70%
Fetal blood flow to coronaries (%)
3%
First degree heart block a/w :
(PR interval prolonged 2/2 delay in AV node)
myocarditis
digoxin toxicity
hypERkalemia
hypOthyroid
congenital heart disease
(tx not usually needed)
Two equations for Cardiac Output
CO = HR x Stroke Volume
CO = Systemic BP / Total PVR