Cardiology Flashcards
What is the cause of atrial septal defect?
When foramen ovale doesn’t close
What is the pathology of ASD?
Blood moves from the left to right atrium since pressure is higher on the left
What are the signs of an ASD?
Mid-systolic crescendo-decrescendo murmur
Best heard on the upper left sternal border
Fixed split of the second heat sound
How is ASD investigated?
ECHO
How is ASD treated?
Small - watch and wait
Big - transvenous catheter closure
What are the complications of ASD?
Stroke AF Pulmonary hypertension Right sided heart failure Eisenmenger syndrome
What are the associations with ASD?
Down syndrome
Turner syndrome
What is the cause of ventricular septal defects?
The ventricular septum doesn’t form properly
What is the pathology of VSD?
Blood flows from the left to the right
Right sided overload, right sided heart failure, pulmonary hypertension
What are the signs of VSD?
Pan-systolic murmur
Best heard over the lower left sternal border in the 3rd/4th intercostal space
Systolic thrill
How is VSD investigated?
ECHO
What is associated with VSD?
Down syndrome
Turner syndrome
What is the pathology of patent ductus arteriosus?
It doesn’t close
What are the signs of patent ductus arteriosus?
Small may be symptomatic
Normal first heart sound with a continuous crescendo-decrescendo ‘machinery’ murmur that makes the second heart sound difficult to hear
What investigation would be done if patent ductus arteriosus was suspected?
ECHO
How is patent ductus arteriosus treated?
Normally close on their own
What are the 4 co-existing pathologies in tetralogy of fallot?
Ventricular septal defect
Overriding aorta
Pulmonary valve stenosis
Right ventricular hypertrophy
What is tetralogy of fallot associated with?
DiGeorge syndrome
What are the risk factors for tetralogy of fallot?
Rubella
Increased age of the mother
Alcohol consumption
Diabetic mother
What is the pathology of tetralogy of fallot?
Blood flowing between ventricles
Aortic valve placed further to the right (closer to VSD) so deoxygenated blood goes to the body
Pulmonary valve stenosis pushed more deoxygenated blood through the VSD and therefore to the body
What are the signs of tetralogy of fallot?
Ejection systolic murmur (pulmonary stenosis)
Heard loudest at the pulmonary area
Cyanosis
How is tetralogy of fallot treated?
Total surgical repair by open heart surgery
What is the pathology of coarctation of the aorta?
Narrowing of the aortic arch
What are the signs of coarctation of the aorta?
Weak femoral pulses
systolic murmur - heard below the left clavicle (left infraclavicular)
What investigation would be done if coarctation of the aorta was suspected?
4 limb BP - high blood pressure in the limbs before the narrowing, low in the rest
ECHO
How is coarctation of the aorta treated?
Depends on severity
Leave it or surgery
What is associated with coarctation of the aorta?
Turner syndrome
What is the pathology of transposition of the great vessels?
Right ventricle pumps blood into the aorta
Left ventricle pumps blood into the pulmonary vessels
What are the signs of transposition of the great vessels?
Life threatening after birth as no connection between systemic and pulmonary circulation
Cyanosed
How is transposition of the great vessels treated?
Need to form a shunt to wait for surgery
If VSD this is a shunt
If not, give prostaglandins to maintain ductus arteriosus
What are the 8 common lesions?
Ventricular septal defect Patent ductus arteriosus Atrial septal defect Pulmonary stenosis Aortic stenosis Coarctation of the aorta Transposition of the great arteries Tetralogy of fallot
What are the causes of congenital heart disease?
Genetic susceptibility
Environmental hazard
Teratogenic insult - 18-60 days post contraception
Environmental factors - drugs, infections, maternal (DM, SLE)
What are the features of innocent murmurs?
S's: Short Soft Systolic Symptomless
