CHAPTER 5:2 (PART 2) Flashcards
What kind of Surgical Procedures for Heart Defect implies that the heart needs to be opened in order to repair the defect and therefore the “bypass” machine is used to oxygenate and circulate the blood without using the heart or lungs.
Open
-most common signs of CHF
*Respiratory distress signs
*Cough
*diaphoresis
Surgical Procedures for Heart Defect implies that the “heart lung machine” or “bypass” machine is not used and the heart is visualized but not cut open.
Closed
What are the 4 Non-obstructive lesions
- VSD (Ventricular septal defect)
- ASD (atrial septal defect)
- PDA (patent ductus arteriosus)
- Atrioventricular Canal (AVC) Defect
What Non-obstructive lesions is when there is Abnormal opening between R+ L auricies (Atrial allowing blood from higher pressure LA to flow into the lower pressure RA crossing the pulmonic valve
ASD (atrial septal defect)
What Non-obstructive lesions is when LA pressure exceeds the RA pressure causes increase flow of oxygenated blood into the R side of the heart Management
ASD (atrial septal defect)
What Non-obstructive lesions causes Overloading of the RVentricle → R. Ventricular Hypertrophy
ASD (atrial septal defect)
What Non-obstructive lesions remains unnoticed in infancy and childhood until pulmonary hypertension is included causing late cyanotic heart disease and right-sided heart failure?
ASD (atrial septal defect)
Isolated ASD comprises about how many percent of congenital heart diseases?
10%
Blood flows across the atrial septum (arrow) from left to right. The murmur is produced by increased flow velocity across the pulmonary valve, as a result of left-to-right shunting and a large stroke volume. The density of shading is proportional to velocity of blood flow.
ASD (atrial septal defect)
It is when During fetal heart devt, the partitioning process does not occur completely, leaving an opening in the atrial septum
ASD (atrial septal defect)
It allows oxygenated (red) blood to pass from the left atrium, through the opening in the septum, and then mix with unoxygenated (blue) blood in the right atrium
ASD (atrial septal defect)
What condition is when blood passes through the this, from the left atrium to the right atrium → a larger volume of blood than normal must be handled by the right side of the heart → extra blood then passes through the pulmonary artery into the lungs → pulmonary hypertension and pulmonary congestion
ASD (atrial septal defect)
What phenomenon is the occurrence of reversal of the pressure gradient across the ASD causes the shunt to reverse –> a right-to- left shunt will exist
Eisenmenger’s syndrome
TYPES of ASD (atrial septal defect):
- Fossa Ovalis type or Ostium Secundum type
- Ostium Primum type
- Sinus venosus type
What TYPE of ASD (atrial septal defect) is the most common form comprising about 90% cases of ASD. The defect is situated in the region of the fossa ovalis that, in utero, was the foramen ovale
Fossa Ovalis type or Ostium Secundum type
What TYPE of ASD (atrial septal defect) comprises about 5% cases of ASD. The defect lies low in the interatrial septum adjacent to atrioventricular valves. There may be cleft in the aortic leaflet of the mitral valve producing mitral insufficiency.
Ostium Primum type
What TYPE of ASD (atrial septal defect) accounts for about 5% cases of
ASD. The defect is located high in the interatrial
septum near the entry of the superior vena cava.
Sinus venosus type
What ACYANOTIC HEART DISEASE have complications like:
*Pulmonary hypertension
* Enlargement of the right side of the heart
*At a later stage, the pressure on the right side is higher than on the left side creating late cyanotic heart disease.
* Endocarditis
ASD (atrial septal defect)
Management for ASD (atrial septal defect) in which it helps strengthen the heart muscle, enabling it to pump more efficiently
digoxin
Management for ASD (atrial septal defect) in which it relieve pulmonary congestion
diuretics
Management for ASD (atrial septal defect) in which, such as prophylactic antibiotics to prevent bacterial endocarditis before dental procedures and other invasive procedures
infection control
Management for ASD (atrial septal defect) in which the patient is placed on cardiopulmonary bypass (the heart-lung machine), the right atrium is then opened to allow access to the atrial septum below - defect may be closed with stitches or a special patch.
surgical repair
What management for ASD (atrial septal defect) in which, For larger ASDs, a patch is usually used to close the hole. This patch can be taken from the pericardium (the sac that surrounds the heart) or from synthetic materials such as Dacron or Teflon.
Dacron Patch Closure
What management for ASD (atrial septal defect) in which, This technique involves
implantation of one of several devices (basically single or double wire frames covered by fabric) using cardiac catheterization
Transcatheter Device Closure
What management for ASD (atrial septal defect) in which, it involves slowly moving a catheter (a long, thin, flexible, hollow tube) into the heart. The catheter is initially
inserted into a large vein through a small incision made usually in the inner thigh (groin area) and then is advanced into the heart
cardiac catheterization
What management for ASD (atrial septal defect) in which it is a closure device is
moved through the catheter to the heart and specifically to the location of the heart wall defect
Transcatheter Device Closure
What ACYANOTIC HEART DISEASE is when there is the Abnormal opening between R&L
ventricles creating pulmonary vascular resistance
VSD (Ventricular septal defect)
What ACYANOTIC HEART DISEASE is when the partitioning process does not occur completely, leaving an opening in the ventricular septum.
VSD (Ventricular septal defect)
What ACYANOTIC HEART DISEASE has Clinical Manifestations:
§ Pansystolic murmur
§ Cardiac failure (in infants)
§ Eisenmenger’s Syndrome
§ Parasternal pulsation
§ Tachypnea
§ Indrawing of the lower ribs on inspiration
VSD (Ventricular septal defect)
What ACYANOTIC HEART DISEASE is when it allows oxygenated blood to pass from the left ventricle, through the opening in the septum, and then mix with unoxygenated blood in the right ventricle.
VSD (Ventricular septal defect)
What is contraindicated in fully developed Eisenmenger’s syndrome when heart-lung transplantation may be the only effective treatment.
Surgical closure
Cardiac failure in infancy is initially treated medically with what kind of medicines
digoxin and diuretics
What ACYANOTIC HEART DISEASE is seen
more often in the following:
* premature infants
*infants born to a mother who had rubella during the first trimester of pregnancy
PDA (patent ductus arteriosus)
What ACYANOTIC HEART DISEASE has Complications:
*Pulmonary hypertension
* Enlargement of the right side of the heart
*At a later stage, the pressure on the right side is higher than on the left side creating late cyanotic heart disease.
VSD (Ventricular septal defect)
What What ACYANOTIC HEART DISEASE has Complications
*Pulmonary hypertension
* Enlargement of the right side of the heart
*At a later stage, the pressure on the right side is higher than on the left side creating late cyanotic heart disease
PDA (patent ductus arteriosus)
What kind of care is pulmonary artery banding
Palliative
Type of Atrioventricular Canal (AVC) Defect in which the hole does not extend between the lower chambers of the heart and the valves are better formed.
Partial atrioventricular canal defects
This procedure is done by Placing a band around the pulmonary artery to decrease the pulmonary blood flow
pulmonary artery banding
This procedure increases the resistance to blood flow through the pulmonary artery. Pressure increases in the right ventricle and
prevents excess shunting from left to right
pulmonary artery banding
a management for PDA (patent ductus arteriosus) that may help close a PDA works by stimulating the muscles inside the PDA to constrict, thereby closing the connection
Indomethacin IV (prostaglandin inhibitor)
What ACYANOTIC HEART DISEASE is when Blood flows from higher pressure aorta to
lower pulmonary artery → LR shunt (BECAUSE SYSTEM PRESSURE EXCEEDS PULMONARY PRESSURE)
PDA (patent ductus arteriosus)
What ACYANOTIC HEART DISEASE is when there is Communication between PA + aorta due to failure of ductus arteriosus to close after birth (1 week of life)
PDA (patent ductus arteriosus)
What ACYANOTIC HEART DISEASE account for about 5 percent of all congenital heart disease, and are most common in infants with down syndrome.
Atrioventricular Canal (AVC) Defect
What ACYANOTIC HEART DISEASE is when there is a connection between the aorta and the pulmonary artery with left-to-right shunting
persistent ductus arteriosus
What ACYANOTIC HEART DISEASE is Also known as endocardial cushion defects
Atrioventricular Canal (AVC) Defect
Type of Atrioventricular Canal (AVC) Defect that is a severe defect in which there is a large hole in the septum that separates the left and right sides of the heart. The hole is in the center of the heart, where the upper chambers and the lower chambers meet
Complete atrioventricular canal (CAVC)
Types of Atrioventricular Canal (AVC) Defect:
- Complete atrioventricular canal (CAVC)
- Partial atrioventricular canal defects
Type of Atrioventricular Canal (AVC) Defect that ) is a severe defect in which there is a large hole in the septum that separates the left and right sides of the heart. The hole is in the center of the heart, where the upper chambers and the lower chambers meet
Complete atrioventricular canal (CAVC)
Type of Atrioventricular Canal (AVC) Defect that ) where The hole does not extend between the lower chambers of the heart and the valves are better formed
Partial atrioventricular canal defects
It is also called atrioventricular septal defect, or AVSD.
Partial atrioventricular canal defects
What ACYANOTIC HEART DISEASE where:
* blood to travel from the left side of the heart to the right side of the heart, or the other way around.
* The oxygenated and unoxygenated blood
being mixed up
* The extra blood being pumped into the lung arteries makes the heart and lungs work harder and the lungs can become congested.
Atrioventricular Canal (AVC) Defect
What ACYANOTIC HEART DISEASE has CLINICAL MANIFESTATION:
* Dyspnea
* MILD CYANOSIS
* A newborn baby will show signs of heart
failure such as edema, fatigue, wheezing,
sweating and irregular heartbeat
* CHARACTERSTIC MURMUR
Atrioventricular Canal (AVC) Defect
What are the 3 Obstructive lesions
- Pulmonic Stenosis (PS)
- Atrial Stenosis (AS)
- Coarctation of Aorta (COA)
What ACYANOTIC HEART DISEASE is the Narrowing at the entrance of PA
Pulmonic Stenosis (PS)
- extreme form of PS; total fusion of commissures; no blood flow to the Left
Pulmonic Atresia
What ACYANOTIC HEART DISEASE has Clinical manifestations
* May be asymptomatic
* Some had mild cyanosis
* Newborn with severe narrowing- cyanotic
* Characteristic murmur
* Cardiomegaly on chest radiograph
Pulmonic Stenosis (PS)
Treatment for those at risk for infective endocarditis with progressive narrowing
lifelong infective endocarditis prophylaxis
What ACYANOTIC HEART DISEASE has Complications:
* Infective endocarditis
* Right ventricular hypertrophy
* CHF
Pulmonic Stenosis (PS)
What management for PA when a doctor inserts a long, thin tube (catheter) with a
balloon on the tip into an artery in the arm or groin.
Balloon Valvuloplasty
What ACYANOTIC HEART DISEASE is when blood is unable to flow freely from the eft ventricle to the aorta during aortic stenosis
Atrial Stenosis (AS)
What ACYANOTIC HEART DISEASE Causes the resistance to ejection of blood from LV > which cause the hypertrophy
Atrial Stenosis (AS)
What ACYANOTIC HEART DISEASE when there is Narrowing of the stricture of the aortic valve causes ↑ pressure in the heart -> L ventricular hypertrophy
Atrial Stenosis (AS)
Types of Atrial Stenosis (AS)
- Valvular stenosis
- Sub valvular stenosis
- Supra valvular stenosis
Type of Atrial Stenosis (AS) that occurs infrequently
Supra valvular stenosis
Type of Atrial Stenosis (AS) which is the most common type and is usually caused by malformed cusps
Valvular stenosis
Type of Atrial Stenosis (AS) which is a stricture caused by a fibrous ring below the normal valve
Sub valvular stenosis
What is regarded as the first step in the management of symptomatic neonates affected with Atrial Stenosis (AS)
Percutaneous balloon valvuloplasty
What ACYANOTIC HEART DISEASE is when there is Narrowing of the aortic lumen specifically in the region where the ductus arteriosus joins the aorta, i.e. at the isthmus just below the origin of the left subclavian artery
Coarctation of Aorta (COA)
What management for Pulmonic Stenosis (PS) which is a cardiac surgery operation where a diseased aortic valve is replaced with the person’s own pulmonary valve
Ross-Yacoub procedure (or pulmonary autograft)
What conditions in Acyanotic (pink baby) are present when with left-to-right shunts
- VSD (Ventricular septal defect)
- PDA (patent ductus arteriosus)
- ASD (atrial septal defect)
Where is cyanosis best recognized
in the tongue and mucus membrane
What conditions in Acyanotic (pink baby) are present when with outflow obstruction
- Pulmonic Stenosis (PS)
- Aortic Stenosis (AS)
- Coarctation of Aorta (COA)
What conditions in Cyanotic (blue baby) are present
· Teralogy of fallot
· Tricuspid atresia
. Transposition of great vessels
. Truncus arteriosus
. Total anomalous pulmonary venous retum (TAPVR)
· Ebstein’s anomaly
a good diagnostic cue for Teralogy of fallot (TOF)
Squatting
Tetrad of cardiac defects is from 4 diseases. what are those 4?
- Pulmonary Stenosis
- Right Ventricular Hypertrophy
- Overriding Aorta
- Ventricular Septal Defect
What CYANOTIC HEART DEFECTS is when there is a hole in the wall that separates the two ventricles of the heart.
Ventricular septal defect (VSD)
What CYANOTIC HEART DEFECTS is when there is a narrowing of the pulmonary valve and artery that reduces blood flow to the lungs.
Pulmonary stenosis
What CYANOTIC HEART DEFECTS is when the aorta, which carries oxygen-rich blood to the body, is positioned over the ventricular septal defect, allowing blood from both ventricles to mix.
Overriding aorta
What CYANOTIC HEART DEFECTS is when the Position of aorta and PA are reversed. The PA leaves the L ventricle and the aorta exists from the Rventricle
Transposition Of Great Vessels /Arteries (TGA/TGV
What CYANOTIC HEART DEFECTS is when the right ventricle of the heart becomes enlarged and thickened due to the increased workload caused by the other three defects.
Right ventricular hypertrophy
What CYANOTIC HEART DEFECTS is present when there is absence of tricuspid or pulmonary valve
Tricuspid atresia
What is the hole called, that helps with the extra blood flow until the lungs as treatment of TRICUSPID ATRESIA (FONTAN PROCEDURE)
fenestration
complication of Transposition Of Great Vessels /Arteries (TGA/TGV) where The body tissues receive too little oxygen (hypoxia). Unless there’s some mixing of oxygen-rich blood and oxygen-poor blood within the body, this complication causes death.
Lack of oxygen to tissues
What CYANOTIC HEART DEFECTS has Manifestations:
* Blue color of the skin (cyanosis)
* Shortness of breath
* Weak pulse
* Lack of appetite
* Poor weight gain
Transposition Of Great Vessels /Arteries (TGA/TGV)
complication of Transposition Of Great Vessels /Arteries (TGA/TGV) where it is a condition in which the heart can’t pump enough blood to meet the body’s needs. It may develop over time because the right lower heart chamber (ventricle) is pumping under higher pressure than usual.
Heart failure
complication of Transposition Of Great Vessels /Arteries (TGA/TGV) where the right lower heart chamber (right ventricle) is pumping blood to the body. This work is different from what the right ventricle was designed to do.
Reduced heart pumping function
complication of Transposition Of Great Vessels /Arteries (TGA/TGV) wherein The changes in the structure of the heart due can disrupt the electrical signals that tell the heart to beat and it occurs if all signals are blocked.
Complete heart block
A procedure to open a hole in the septal wall dividing the left and right atria. The opening in the septum allows oxygen-rich and oxygen-poor blood to mix, improving circulation
Balloon Atrial Septostomy (Rashkind Procedure)
complication of Transposition Of Great Vessels /Arteries (TGA/TGV) where the valve between the upper and lower heart chambers (tricuspid valve) may not close completely, causing blood to move backward.
Heart valve disease
What CYANOTIC HEART DEFECTS is the Failure of normal septation and division of the embryonic bulbar trunk into the pulmonary artery and the aorta, resulting in a single vessel that overrides both ventricles
Truncus Arteriosus
What CYANOTIC HEART DEFECTS is when pulmonary veins are abnormally connected to systemic venous circuit-R ventricular hypertrophyand L atrium remains small
Total anomalous pulmonary venous return(TAPVC/TAPVR(return)/TAPVD (drainage)
What CYANOTIC HEART DEFECTS is Associated ASD allows venous blood to
be shunted from the R atrium to left ventricle
Total anomalous pulmonary venous return(TAPVC/TAPVR(return)/TAPVD (drainage)
What measures the electrical activity of the heart, chest x-rays, and other medical tests may also be used to make the diagnosis.
electrocardiogram (EKG)
what surgery for Hypoplastic Left Heart Syndrome is done within the first 2 weeks of a baby’s life. Surgeons create a “new” aorta and connect it to the right ventricle.
Norwood Procedure
what surgery for Hypoplastic Left Heart Syndrome is usually done sometime during the period when an infant is 18 months to 3 years of age. Doctors connect the pulmonary artery and the vessel (the inferior vena cava) returning oxygen-poor blood from the lower part of the body to the heart, allowing the rest of the blood coming back from the body to go to the lungs.
Fontan Procedure
what surgery for Hypoplastic Left Heart Syndrome is usually performed when an infant is 4 to 6 months of age. This procedure creates a direct connection between the pulmonary artery and the vessel (the superior vena cava) returning oxygen-poor blood from the upper part of the body to the heart
Bi-directional Glenn Shunt Procedure
what CYANOTIC HEART DEFECTS is:
. One great vessel leaving heart
Truncus Arteriosus
what CYANOTIC HEART DEFECTS is:
Two great vessels (pulmonary artery and aorta) are transposed
Transposition of Great Arteries
what CYANOTIC HEART DEFECTS is:
Tricuspid valve fails to form
Tricuspid Atresia
what CYANOTIC HEART DEFECTS is:
. Tetrad of cardiac defects (pulmonary stenosis, RVH, overriding aorta, VSD)
Tetralogy of Fallot
what CYANOTIC HEART DEFECTS is:
5 words; Pulmonary veins do not connect to left atrium
Total Anomalous Pulmonary Venous Return
What position reduces the cardiac output by decreasing the venous return from the lower extremities and by increasing the systemic vascular resistance
The knee-chest position
What positions should be done for patient:
* ACYANOTIC-???
* CYANOTIC-???
- ACYANOTIC-ORTHOPNEIC POSITION
- CYANOTIC-SQUATTING/KNEE-CHEST POSITION
