Congenital Cardiac

Question 1

What is the primitive heart?

Answer 1

Enlarge tube with 3 layers

Question 2

What is cardiac jelly a percursor to?

Answer 2

Endocardial cushion tissue

Question 3

What is the makeup of the primitive heart?

Answer 3

single atrium, two ventricles, truncus arteriosis

Question 4

What is the truncus arteriosis

Answer 4

one single outflow vessel that eventually splits into the 2 great vessels

Question 5

Do the superior and inferior endocardial cushions fuse before the baby is born?

Answer 5

No- they overlap but do not fuse, later become the foramen ovale

Question 6

Where do the AV septum and AV valves come from?

Answer 6

R and L lateral cushions

Question 7

What does the ductus arteriosus do?

Answer 7

Connects pulmonary trunk with aorta

Question 8

What is the function of the umbilical vein?

Answer 8

Delivers oxygen rich nutrients to the fetus

Question 9

Why does blood not go to the lungs in the fetus?

Answer 9

There is higher pressure in the lungs, blood goes to the path or least resistance

Question 10

What is a shunt?

Answer 10

Abnormal path of blood through heart or great vessels

Can be L to R or R to L

Question 11

What is atresia?

Answer 11

complete blocking off

Question 12

What is an acyanotic congenital defect?

Answer 12

Obstructive disorders and L to R shunts

Baby still receives oxygenated blood

Question 13

What are the three types of ASDs?(atrial septal defects)

Answer 13

Ostium primum defect
Ostium secundum defect
sinus venous defect

Question 14

Where is the Ostium primum defect?

Answer 14

Close to the AV valves

Question 15

Where is the ostium secundum defect?

Answer 15

Located near foramen ovale

Question 16

Sinus venous defect is located where?

Answer 16

High in atrial septum

Question 17

What does ASD lead to?

Answer 17

RA and RV enlargement

Question 18

A moderate to large ASD can lead to…

Answer 18

increase in pulmonary blood flow -> pulmonary hypertension

Question 19

VSD leads to

Answer 19

enlargement of pulmonary artery, LA, LV

Question 20

In a VSD what side of the heart will fail first?

Answer 20

Left side

Question 21

Why is there pulmonary hypertension with a VSD?

Answer 21

Pulmonary vessels undergo structural change

rising pulmonary vascular resistance

Question 22

What is it called when pulmonary pressure exceeds systemic pressure and the shunt reverses?

Answer 22

Eisenmenger syndrome

Question 23

What is Patent Ductus Arteriosus (PDA)?

Answer 23

A PDA (connects pulmonary trunk to aorta) doesn’t constrict after birth

Question 24

What side of the heart becomes the primary pump with a PDA?

Answer 24

Left (ventricle)

Question 25

What symptoms will the baby show with a PDA?

Answer 25

Huge murmur Bounding pulses large different b/w systolic and diastolic

Question 26

What is coarctation of the aorta (COA)?

Answer 26

Narrowing of aorta

Question 27

What is a preductal COA? (with PDA)

Answer 27

coarctation before the PDA | R ventricle becomes primary pump (because it pumps to systemic through PDA)

Question 28

Problem with postductal COA

Answer 28

R ventricle can't pump through PDA (because narrowing is after it) Acyanotic

Question 29

What is pulmonary stenosis?

Answer 29

Narrowing of the pulmonary outflow tract

Question 30

What is pulmonary atresia?

Answer 30

Severe form, complete fusion of commissures

Question 31

In pulmonary stenosis/ atresia what hapens to the RV?

Answer 31

Hypertrophies to maintain adequate CO

Question 32

If there is a severe pulmonary obstruction, what can happen?

Answer 32

Foramen ovale may reopen

Question 33

What are the 4 defects w/ tetralogy of fallot?

Answer 33

VSD high in septum overriding aorta straddling VSD Pulmonary stenosis RV hypertrophy

Question 34

What happens with the Tetralogy of Fallot?

Answer 34

Both chambers send blood through aorta

Question 35

What allows a pink tets baby?

Answer 35

Little pulmonary stenosis w/ Tetralogy of Fallot

Question 36

What allows a blue tets baby?

Answer 36

High pulmonary resistance with Tetraology of Fallot

Question 37

Why does adding a PDA to Tetraology of Fallot help?

Answer 37

Blood can flow into the pulmonary system via the PDA and have adequate oxygen in blood

Question 38

What happens with the Transposition of the Great Vessels?

Answer 38

``` Aorta connect with Right ventricle Pulmonary trunk connects with L ventricle Unoxygenated blood through system oxygentated blood through pulmonary the two never mix ```

Question 39

What can allow a baby to survive with the transposition of the great vessels?

Answer 39

Adding a PDA, ASD, or VSD so the two circuit mix

Question 40

What is truncus arteriosus?

Answer 40

Failure of large embryonic artery and truncus arteriosis to divide Single vessel from both ventricles Straddles always present VSD

Question 41

IN truncus arteriosus where do most the blood travel to?

Answer 41

The lungs as the pulmonary resistance is lower but can lead to pulmonary vascular disease

Question 42

What is tricuspid atresia?

Answer 42

no blood can flow through triscuspid valve (R atria to R ventricle) *often accompanied with transposition of the great vessels

Question 43

Adding what defects can help tricuspid atresia (allows blood to flow to lungs)?

Answer 43

VSD, PDA