Cardiology

Question 1

Describe an ASD

Answer 1

Defect in the wall of the atrium leading to a L to R shunt, due to pressure gradient.

Question 2

Give some conditions that ASDs are associated with

Answer 2

Downs Syndrome
Ebsteins anomaly 
Fetal Alcohol Syndrome
Holt-Oram Syndrome
Lutenbacher's Syndrome

Question 3

Give some of the different types of ASDs

Answer 3

Ostium Secundum defect
Patent Foramen Ovale
Ostium Primum defect (although it technically an atrioventricular defect)
Single atrium

Question 4

Describe the symptoms from an ASD

Answer 4

Breathlessness
Congestive Heart Failure 
Pulmonary Hypertension
Stroke
- Tends to be in untreated adults

Question 5

How are ASDs diagnosed?

Answer 5

Often seen on USS in utero

Found on physical examination

Question 6

What is the treatment for ASD?

Answer 6

Watch and wait - may close on own
Surgery
- Percutaneous
- Open repair

Question 7

When is ASD repair performed?

Answer 7

Lowest mortality is performed before pulmonary hypertension has developed (lowest when pressure is less than 40mmHg)

Question 8

What are some complications which occur from ASD?

Answer 8

Increased risk of cardiac arrhythmias
Frequent resp. infections 
RF for decompression sickness 
Eisenmenger's syndrome 
Paradoxical embolus

Question 9

What is Holt-Oram syndrome?

Answer 9

AD condition, affects bones in the arms and hands as well as causing heart problems.

Question 10

What are the classical signs in Holt-Oram Syndrome?

Answer 10

Absent radial bone
ASD
First degree heart block

Question 11

Define Ebstein’s anomaly

Answer 11

Congenital heart defect.

Tricuspid valve leaflets are displaced towards the apex of the RV, often associated with an ASD.