common congenital cardiac lesions Flashcards
location of a secundum ASD
centre of atrial septum
location of primum ASD
parital AVSD
-at crux of heart
presenation of ASD
usually asympotmatic in childhood
incidental murmur
later in life may present with breathlessness and arrhythmias
managemnt of secundum ASD 2
transcatheter device closure
surgical repair
management of primum ASD 1
surgical- needs to be open
prognosis of ASD
good long term outlook
prevalence of VSD
2/1000 births
how can VSDs be classified 2 and then 3
can. be membranous or msucular part of septum
then defined as small, medium or large
presentation of small VSD
usually asymptomamtic
-around 80% close spontaneously
presentation of large VSD
haemodynamically significant
-can effect left ventircular overload-> ioncreaed pulmonary blood flow and lead to caridac failure
-needs repaired in first 6 months of life
if heart failure due to VSD what is mangemnt 3
diuretics
ACE inhibiotrs
maximise nutrion- often with NG feed s
earlier surgery if child continutes to fail to thrive
what is a patent ductus arteriosus associated with 2
prematurity
maternal rubella
signs on examination of patent ductus arteriosus 2
bounding femoral pulses
continous murmur under left clavicle - subclavicular
complications of patent ductus arteriosus 2
heart failure
failure to thrive
treatment of patent ductus arteriosus in preterm infants 2
NSAIDs -indomethacin or ibruprofen
surgical ligation if medical management fails
treatment of patent ductus arteriosus in older children 1
device occulsion by cardiac catheterisation
how does coarctation of aorta present in neonates 3
collapse
cardiac failure
weak/absent femoral pulses
coarctation of aorta presentation in older chldren/adults 3
raised BP
absent femoral pulses
or
radio-femoral delay
investigation for coarctation of aorta and finding 1
CXR
may show cardiomegaly/ rib notching (in late stages)
treatment for coarctation of aorta in infants 1
surgery
coarctation of aorta treatment in adults
ballon dilation /stenting
commonest neonatal cyanotic condition
transposition of the great arteries
presenation of transposition of the great arteries when ductus arteriosus closes 2
effortless tachypneoa
acidotic
*may not have murmur
managemnt of transposition of the great arteries 4
CXR- looks like an egg on side
prostaglandin to open arteiral duct
?urgent balloon atrial septostomy (BAS) to increase mixing at atrial level
definitive surgery
-artieral switch- good long term outcome
what does tetralogy of Fallot contain
VSD
rigt ventricular outflow tract obstruction
aortic overide VSD
right ventircular hypertorphy
spectrum of presentaion of tetralogy of Fallot 3
minimal RVOT obstruction - pink
fixed obstruction - may become progresssively cyanosed
dynamic obstruction-hypercyanotic spells
biochem in tetralogy of Fallot 1
polycythaemia is characterisitc
CXR for tetralogy of Fallot
boot shaped heart
CXR for transposition of greater arteries
egg on side
what is tetralogy of Fallot assoicated with 2
Di george syndrome
Downs
