Cardiovascular Disorders

Question 1

Ventricular septal defect

Answer 1

• Early L-to-R shunt
• LV dilation and CHF
• Increased pulmonary vascular resistance may cause R-to-L shunt —> late cyanosis, RVH, R side failure

Question 2

Atrial septal defect

Answer 2

• Ostium secundum defect most common; L-to-R shunt may cause R side enlargement
• Later in life: R-to-L shunt w/ cyanosis, clubbing, atrial arrhythmia, pulmonary HTN, RVH, failure, paradoxical emboli

Question 3

Patent ductus arteriosus

Answer 3

• Aorta —> pulmonary artery
• Common in rubella, Down syndrome, DiGeorge syndrome
• LVH, failure, pulmonary HTN

Question 4

Persistent truncus arteriosis

Answer 4

• Common trunk of aorta, pulmonary arteries, coronary arteries
• Always overrides VSD
• Often causes early death
• Otherwise, pulmonary vascular changes cause cyanosis, clubbing, polycythemia

Question 5

Hypoplastic L heart syndrome

Answer 5

• All cardiac output from R heart thru patent ductus arteriosus
• Infants are well initially but die w/in first month

Question 6

Anomalous pulmonary vein drainage

Answer 6

• Pulmonary veins drain into caval vein

* No venous return to L heart, requires ASD or patent foramen ovale

Question 7

Tetralogy of Fallot

Answer 7

• Pulmonary stenosis, VSD, dextroposed aorta (overrides VSD), RVH
• Boot-shaped heart
• Slow physical development, DOE, cerebral thromboses from polycythemia

Question 8

Transposition of the great arteries

Answer 8

• Aorta and pulmonary artery from opposite ventricles
• More common in diabetic mothers
• Some communication via ASD, VSD, or patent ductus arteriosus

Question 9

Coarctation of the aorta

Answer 9

• Narrowing of aorta below L subclavian
• BP differential b/w upper and lower extremities w/ LVH
• Lightheadedness, HA, epistaxis, rupture of berry aneurysms
• Weakness, cold, pallor of BLE
• Notched ribs
• Death before age 40

Question 10

Nonbacterial thrombotic/marantic endocarditis

Answer 10

• Associated with wasting diseases
• Sterile vegetations on mitral or aortic valve
• May be associated with distant thrombi

Question 11

Carcinoid heart disease

Answer 11

• Associated with carcinoid tumors (usu. small intestine)
• Dense, gray, fibrous plaques on tricuspid and pulmonic valves
• Tricuspid regurgitation and pulmonary stenosis