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Spring Cardiac Theory > Congenital > Flashcards

Congenital Flashcards

1
Q

What is SINUS OF VALSALVA ANUERYSM?

A

aneurysm of one of the sinus’, appears as a thin dilated area that projects into adjacent cardiac structures often with a fistula

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2
Q

Draw out what a SINUS OF VALSALVA ANEURYSM would look like & in the view you would see it in

A

PSSAX AV

NCC - into RA
LCC - into LA
RCC - into RV

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3
Q

What is a CORONARY AV FISTULA?

A

rare congenital anomaly where there is an abnormal communication from coronary artery to coronary sinus

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4
Q

When does a CORONARY AV FISTULA present?

A

in young adults as continuous murmur

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5
Q

What is seen on ECHO of a CORONARY AV FISTULA?

A
  1. receiving vessel/chamber & proximal coronary artery may be dilated
  2. may see echolucent entro site
  3. may see abnormal color flow into vessel/chamber
  4. may see disturbed color flow in fistula
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6
Q

What is EBSTEIN ANOMALY?

A

one (usually septal) or more of the TV leaflets are adhered to RV endocardium

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7
Q

Draw out what EBSTEIN ANOMALY would look like

A
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8
Q

Define LEVOCARDIA

A

apex towards left

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9
Q

Define DEXTROCARDIA

A

apex towards right

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10
Q

Define SITUS SOLITUS

A

normal position of thoracic and abdm organs

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11
Q

Define SITUS INVERSUS

A

organs of chest and abdm are arranged in a perfect mirror image reversal of the normal position

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12
Q

Define & Draw out NORMAL POSITION SITUS SOLITUS

A

normal position of thoracic and abdm organs with apex to left

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13
Q

Define & Draw out SITUS INVERSUS WITH DEXTROCARDIA

A

organs of chest and abdm switched with apex to right

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14
Q

Define & Draw out SITUS SOLITUS WITH DEXTROCARDIA

A

normal position of thoracic and abdm organs BUT apex to right

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15
Q

Define & Draw out SITUS INVERSUS WITH LEVOCARDIA

A

organs of chest & abdm switched BUT apex to left

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16
Q

what is the FIRST and SECOND most common congenital defect in adults?

A
  1. bicuspid AV
  2. ASD
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17
Q

What are the types of ASDS?

A
  1. secundum
  2. primum
  3. sinus venosus
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18
Q

What is a SECUNDUM ASD and DRAW it out

A

defect at the central section of IAS at fossa ovalis

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19
Q

Name a type of SECUNDUM

A

patent foramen ovale

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20
Q

What is a PFO and DRAW it out

A

lesser form of ASD and it’s failure of the foramen ovale to close

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21
Q

What is a PRIMUM ASD and DRAW it out

A

ASD inferior to secundum, located near atrioventricular connection

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22
Q

What is a SINUS VENOSUS?

A

defect at the base of LA, superior and posterior near junction of SVC and RA

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23
Q

A Sinus Venosus may be associated with what?

A
  1. PAPVR (partial anomalous pulmonary venous return)
  2. TAPVR
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24
Q

What is the most common form of ASD and what is it associated with?

A

-secundum
-MVP

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25
Q

PRIMUM ASD is associated with what abnormalities?

A

abnormalities of the atrioventricular valves like:
1. AV canal defect
2. cleft (divided) AMVL

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26
Q

What are the ECHO FINDINGS for ASDs?

A
  1. color jet across atrial septum into RA
  2. RAE, RVE,PSM due to increased volumes
  3. L - R shunt bc LA pressure > RA
  4. may have IAS aneurysm
  5. “T” artifact in apical
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27
Q

What are DOPPLER FINDINGS for ASDs?

A
  • PW location, CW velocity, Qp/Qs severity
  • low velocity flow; slightly faster in diastole due to pressure
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28
Q

What are the TYPES of VSDs and WHERE are they located?

A

1.membranous/perimembranous - membranous septum

  1. muscular/trabecular- any location in the muscular portion of the septum
  2. inlet - below AV between TV and MV annulus
  3. supracristal/outlet - RVOT portion of septum
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29
Q

What are the ECHO FINDINGS for VSDs?

A
  1. LAE, hyperdynamic LV or LVE due to LV volume overload
  2. color jet LV to RV
  3. PISA may be seen on left side of IVS if signif.
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30
Q

What can lead to PHTN in regards to VSDs?

A

large shunts

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31
Q

What ECHO findings would you suspect if there is PHTN in VSDs?

A

RVH, RVE & subsequent Eisenmenger (R-L)

32
Q

DRAW OUT a view you see MEMBRANOUS VSD?

A
33
Q

DRAW OUT a view you see MUSCULAR/TRABECULAR VSD?

A
34
Q

DRAW OUT a view you see INLET VSD?

A
35
Q

DRAW OUT a view you see SUPRACRISTAL/OUTLET VSD?

A
36
Q

What are you doing in terms of DOPPLER for VSDS?

A
  • PW for location
  • CW for velocity - high velocity in systole (5-6m/s)
  • brief flow reversal less likely so saline not used
  • color doppler is highly sensitive to signif VSDs
  • QpQs not needed in adults
37
Q

What is the expected velocity in VSDs?

A

high velocity flow (~5m/sec) during systole due to high LV systolic pressures

38
Q

what is the most COMMON type of VSD?

A

perimembranous

39
Q

what ABNORMALITY is common with perimembranous VSD?

A

AI

40
Q

what is the SECOND most COMMON VSD?

A

muscular/trabecular

41
Q

what is OUTLET/SUPRACRISTAL VSD associated with?

A

60-70% have RCC prolapse

42
Q

What is a PATENT DUCTUS ARTERIOSUS?

A

fetal communication between descending aorta and pulmonary artery that remains open after birth

43
Q

DRAW out what a PDA would look like

A
44
Q

What are the ECHO FINDINGS for PDA?

A
  1. LAE and LVE due to chronic overload
  2. color flow shows red jet towards transducer in diastole in the PA
  3. flow and murmur are continuous
45
Q

What are the DOPPLER FINDINGS for PDA?

A
  1. CW Doppler looks like PI due to normal antegrade flow through PV
  2. PW in DA shows holodiastolic flow reversal similar to severe AI
  3. shunt ratio can determine severity
46
Q

What is PAPVR? And what may it be associated with?

A
  • when one or more PV drain into RA or SVC or IVC
  • sinus venosus ASD
47
Q

What is AV CANAL DEFECT? DRAW it out

A

consists of large inlet VSD which may extend to atrial septum creating ASD and one large atrioventricular valve

48
Q

AV Canal Defect is most seen in?

A

down syndrome

49
Q

AV Canal Defect may be associated with what?

A
  1. primum
  2. malformation of atrioventricular valves
50
Q

What is an AORTIC COARCTATION?

A

narrowing of the descending thoracic aorta

51
Q

DRAW out how a DOPPLER of COARCTATION would appear on SSN

A
52
Q

DRAW out how a DOPPLER of COARCTATION would appear on ABDM AO

A
53
Q

What would show in SSN DOPPLER OF COARCTATION?

A

high velocity systolic flow (> 1m/sec) with persistent antegrade diastolic flow “sawtooth”

54
Q

What would show in ABDM AO DOPPLER OF COARCTATION?

A

dampened systolic velocities (~60cm/s) with gradual upstrokes and diastolic continuation

55
Q

Aortic Coarctation is often associated with what?

A

bicuspid AV

56
Q

What is EISENMENGERS?

A

a R to L shunt in result of large shunt causing PHT to cause R pressures to exceed L pressures

57
Q

DRAW out how EISENMENGERS would appear

A

right to left shunt

58
Q

What is TETRALOGY OF FALLOT?

A

VSD, PS, RVH and override aorta

59
Q

What does CCTGA stand for?

A

congenitally corrected transposition of the great arteries

60
Q

What is CCTGA also known as?

A

L-transposition/ventricular inversion

61
Q

What is L-TRANSPOSITION/CCTGA?

A

ventricular inversion where only the ventricles have switched places

62
Q

With L-transposition
The RV with TV serves as what?
The LV with MV serves as what?

A
  • systemic ventricle
  • pulmonary ventricle
63
Q

What makes L-transposition UNCOMPLICATED?

A
  1. pathway of blood is normal
  2. dx may be made incidentally in adulthood
64
Q

What makes L-transposition COMPLICATED?

A

if associated with defects such as VSDs, PS, complete heart block and Ebstein

65
Q

CCTGA can present with what?

A

dextrocardia

66
Q

DRAW out what CCTGA would look like

A
67
Q

What is TGA? and DRAW it out

A

transposition of the great arteries where Aorta originates from RV and PA from LV

68
Q

TGA is also known as?

A

D- transposition

69
Q

What occurs with PERSISTENT LEFT SVC?

A
  • SVC drains into coronary sinus
70
Q

What ECHO FINDING suggests PERSISTENT SVC?

A

dilated coronary sinus in PLAX

71
Q

Where is the QP AND QS site for VSD?

A

Qp- RVOT
Qs- LVOT

72
Q

Where is the QP AND QS site for ASD?

A

Qp- RVOT
Qs- LVOT

73
Q

Where is the QP AND QS site for PDA?

A

Qp- LVOT
Qs- RVOT

74
Q

What is BORDERLINE for QpQs?

A

1.5 - < 2

75
Q

What is SIGNIFICANT for QpQs?

A

> 2

76
Q

what is ENDOCARDIAL CUSHION DEFECT?

A

abnormal chordal attachments; consists of large VSD which may extend to atrial septum creating ASD and create one large atrioventricular valve

77
Q

Endocardial cushion defect is seen in what type of patients?

A

down syndome

Spring Cardiac Theory (11 decks)

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