CHD of the Right Heart Flashcards

1
Q

What is pulmonary stenosis? (PS)

A

Narrowing of the OV causing obstruction to RVOT flow

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2
Q

Is congenital or acquired PS more common?

A

Congenital, most often in pediatric pt’s and rarely seen in adults

If acquired, typically from carcinoid syndrome

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3
Q

What does PS do to the RV and RA?

A

RVH (increased pressures)

RA dilation

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4
Q

What is most commonly associated with PS?

A

Maternal rubella
Clubbed fingers
Turner’s
Noonan’s
Polycythemia Vera

*Peripheral PAS associated w/ William’s
*Infundibular PAS associated w/TOF

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5
Q

What are S+S of PS?

A

SOB
SOBOE
Chest pain
Syncope
Fatigue

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6
Q

What US finding is most commonly seen with PS? (Hint: septal defect)

A

VSD

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7
Q

What happens to the PV leaflets with PS?

A

Thickened
Doming in systole

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8
Q

If the PS jet is eccentric, what can happen to the MPA?

A

Dilation

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9
Q

What is an M-Mode finding with PS?

A

Increased A - wave

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10
Q

What is Pulmonary Atresia?

A

Absence of PV opening

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11
Q

With Pulmonary Atresia, how does the PA get blood?

A

Ductus arteriosus

*Must remain open after birth! Or have associated defects

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12
Q

What is associated with Pulmonary Atresia?

A

VSD with overriding Ao

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13
Q

What is Tricuspid Atresia?

A

Absence of TV opening

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14
Q

What associated defects must be present for survival with Tricuspid Atresia?

A

VSD AND PFO

  • once PDA closes, no deoxygenated blood can reach the PA without a VSD and PFO
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15
Q

What happens to the heart chambers with Tricuspid Atresia?

A

Hypoplastic RV
Biatrial enlargement with PFO (R to L or bi-directional)

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16
Q

What is Ebstein Anomaly?

A

When the TV originates very inferior, toward the apex

17
Q

Are the TV annuli inferior or in their normal position with Ebstein’s?

18
Q

What is the normal measurement (in mm and mm/m^2) of distance between the TV and MV

A

20 mm
8 mm/m^2

19
Q

What happens to the heart chambers with Ebstein’s?

A

Very large RA ++++
Small RV
Small, ‘D’ shaped LV

20
Q

What does Ebstein’s cause?

21
Q

What is associated with Ebstein’s?

A

Secundum ASD (most common), R to L shunt

30% have WPW

22
Q

What is Eisenmenger’s Syndrome

A

Occurs when there is a shunt between the L and R side. Normal shunt flow is from R to L, but if the right pressures exceed the L, the shunt direction reverses

23
Q

What does Eisenmenger’s cause?

A

Cyanosis and right heart failure

24
Q

What defect does Eisenmenger’s usually occur with?

A

VSD (most common)
ASD, PDA, AVCD

25
What is a Persistent Left SVC (PLSVC)
Blood from left UE drains directly into the coronary sinus through the brachiocephalic vein
26
What would we most commonly see on US with PLSVC? What if we used contrast?
Dilated coronary sinus If saline contrast is injected into the left arm, and the coronary sinus fills BEFORE the RA, PLSVC is present
27
What is an Aortopulmonary Window? (AoPW)
A direct connection between the AscAo and MPA (L to R shunt, unless Eisenmenger's is present)
28
What does an Aortopulmonary Window do to the descending aorta?
Diastolic flow reversal
29
What murmur is heard with diastolic flow reversal in the Desc Ao from an AoPW?
Continuous murmur
30
What are S+S of AoPW?
Respiratory infection Tachypnea Tachycardia
31
What can occur as a result of AoPW?
CHF PHTN
32
What is a Patent Ductus Arteriosus? (PDA)
When DA doesnt close after birth and blood continues to shunt from the descending Ao to the PA
33
What does a PDA cause?
Cyanosis, especially in the lower extremities LVVO, dilated LV and LA May see diastolic flow reversal in desc Ao