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D&T3 Exam I > Cardiovascular Congenital Disorders > Flashcards

Cardiovascular Congenital Disorders Flashcards

1
Q

Left-to-right shunts (4):

A
  • ASD
  • VSD
  • PDA
  • AV septal defect
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2
Q

In ASD the degree of left-to-right shunt is determined by:

A

The size of the defect and right ventricular compliance

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3
Q

ASD leads to (3):

A
  • Right atrial enlargement
  • Right ventricular enlargement
  • Increased pulmonary blood flow
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4
Q

ASD on physical exam (4):

A
  • Prominent RV impulse
  • Widely split and fixed second heart sound
  • Soft systolic ejection murmur at left upper sternal border
  • Diastolic murmur at left lower sternal border with large shunts
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5
Q

Most common form of congenital heart disease:

A

VSD

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6
Q

VSD leads to (3):

A
  • Left atrial enlargement
  • Left ventricular enlargement
  • Increased pulmonary blood flow
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7
Q

Degree of shunt in VSD depends on (2):

A
  • Size of the defect

- Pulmonary vascular resistance

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8
Q

VSD physical exam findings (4):

A
  • Hyperdynamic precordium
  • Holosystolic murmur at the left lower to mid-sternal border
  • Mid-diastolic rumble at the apex with large shunts
  • Hepatomegaly
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9
Q

Degree of shunt in PDA depends on (2):

A
  • Size of the ductus

- Pulmonary vascular resistance

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10
Q

PDA leads to:

A

Left atrial and left ventricular volume overload

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11
Q

Clinical features of PDA:

A

May present with tachypnea, diaphoresis and feeding difficulties

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12
Q

PDA on physical exam (3):

A
  • Hyperdynamic precordium
  • Continuous harsh “machine-like” murmur
  • Tachypnea and hepatomegaly may be present
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13
Q

Pathology of a partial AVSD (3):

A
  • Primum atrial septal defect
  • Two atrioventricular valve annuli
  • Cleft mitral valve
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14
Q

Pathology of complete AVSD (3):

A
  • Primum atrial septal defect
  • Inlet ventricular septal defect
  • Single atrioventricular valve annulus
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15
Q

Partial AVSD on physical exam (3):

A
  • RV impulse
  • Fixed split S2
  • Systolic ejection murmur at the left upper sternal border
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16
Q

Complete AVSD on physical exam (3):

A
  • Hyperdynamic precordium
  • Loud S2
  • Holosystolic murmur at the left lower to mid-sternal border
    • Initially there may be no murmur
17
Q

ECG in complete AVSD:

A

Prolongation of the PR interval and a leftward or superior QRS axis

18
Q

Coarctation of the aorta is associated with:

A

Bicuspid aortic valve

19
Q

Coarctation of the aorta clinical features (2):

A
  • Infants with severe coarctation present with CHF as the ductus closes
  • Older children/adolescents may present with a murmur and HTN
20
Q

Coarctation of the aorta on physical exam (3):

A
  • Respiratory distress with poor perfusion
  • Diminished or absent femoral pulses
  • Gallop rhythm may be heard
21
Q

Management for coarctation of the aorta includes (3):

A
  • PGE1 to maintain ductal patency
  • Correction of metabolic acidosis
  • Inotropic support for myocardial dysfunction
22
Q

Hypoplastic left heart syndrome on physical exam (5):

A
  • Mild cyanosis
  • Increased work of breath and decreased perfusion as the ductus closes
  • Single loud S2
  • Nonspecific systolic ejection murmur
  • Possible gallop
23
Q

Pathology of tetralogy of Fallot (4):

A
  • Large VSD
  • Overriding of the aorta
  • RV outflow tract obstruction
  • RV hypertrophy
24
Q

Tetralogy of Fallot on physical exam (2):

A
  • Single S2

- Harsh systolic ejection murmur along the left sternal border that radiates into the back

25
Q

Tet spells (2):

A
  • Severe and often prolonged arterial desaturation
  • Acute and significant increase in R-L shunting secondary to a change in the ratio of pulmonary and systemic vascular resistance
26
Q

Tet spells are characterized by (5):

A
  • Irritability
  • Hyperpnea
  • Marked cyanosis
  • Pallor
  • Lethargy or unconsciousness
27
Q

Clinical features of tricuspid atresia (4):

A
  • Cyanosis in the neonatal period
  • LV impulse
  • Single S2
  • Systolic murmur
28
Q

Clinical features of transposition of the great arteries (2):

A
  • Cyanosis in the neonatal period

- Single S2

29
Q

Clinical features of truncus arteriosus (4):

A
  • Symptoms of HF with mild cyanosis
  • Single S2
  • Holosystolic murmur from the VSD
  • Systolic ejection click and diastolic murmur from truncal valve regurgitation
30
Q

Unobstructed TAPVR presents with (4):

A
  • Feeding problems
  • Tachypnea
  • Poor growth
  • Respiratory infection
31
Q

Unobstructed TAPVR on physical exam (4):

A
  • RV impulse
  • Widely split S2
  • Systolic ejection murmur at left upper sternal border
  • Diastolic rumble at left lower sternal border
32
Q

Obstructive TAPVR:

A

Respiratory distress and often severe cyanosis on the first day of life

D&T3 Exam I (21 decks)

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