congenital cardiac anomalies Flashcards
4 defects associated with too much pulmonary flow and CHF
ASD
VSD
PDA
COARCTATION OF THE AORTA
which 2 defects is associated with deficient pulmonary flow
aka the concal-truncal defects
tetralogy of fallot
great vessel transposition
which type of shunting is associated with cyanotic defects
R to L shunting
which type of shunting is associated with acyonotic defects
L to R
most common pediatric heart defect
VSD
- loud, harsh, or blowing holosystolic murmur, and are best heard over the lower left sternal border
- dx w/ TTE for position and size; doppler echo for magnitude
VSD
- ejection murmur w/ widened split S2 in all respiratory phases bc the extra blood return during inspiration gets equalized between the left and right atria
- can have harrison grooves d/t atrial enlargement
ASD
how is ASD diagnosed in kids vs adults
- kids– TTE
- adults– TEE
may show heart enlargement and more pulmonary vascular markings on CXR
tx for ASD
closed surgically or percutaneously if over 1 cm
- continuous murmur with like machinery in quality, is best heard in the second left intercostal space; soon after onset of the first sound
- dx w. echo
- doppler shows retrograde turbulent flow in pulm artery and aortic retrograde in diastole
PDA
indomethacin, ibuprofen, and acetaminophen is used to tx what defect?
stable PDA
how to tx hemodynamically unstable and increased impairment PDA
ligate or occlude
can you do ligation or occlusion if severe pulmonary vascular obstructive dz develops in PDA
NO its contraindicated!!!!!
can you do ligation or occlusion if severe pulmonary vascular obstructive dz develops in PDA
NO its contraindicated!!!!!
- Aorta narrowing; occurs mostly below the origin of the left subclavian artery at the origin of the ductus arteriosus
- classic sign of pulsation/BP disparity where femoral pulse comes after radial and BP is lower in legs
coarctation of the aorta
tx for mild aorta coarctation
prostaglandin E1 infusion, which can open the ductus arteriosus and relax the coarctation segment.
definitive tx of aorta coarctation
remove the segment via surgery or transcatheter
what is the tetralogy of fallot (list all 4)
- VSD
- RVOT obstruction
- overriding aorta
- RVH
which two vessels are switched with D-TGA
pulmonary artery and aorta
eisenerger syndrome is associated with which: cyanotic vs acyanotic?
acyanotic
eisenerger syndrome is associated with which: cyanotic vs acyanotic?
acyanotic
how does hypoxia affect the ductus arteriosus
normally arterial oxygen tension + less blood flow allows it to close
if there is no oxygen this discourages the constriction of it
how does hypoxia affect the ductus arteriosus
normally arterial oxygen tension + less blood flow allows it to close
if there is no oxygen this discourages the constriction of it
flow murmur vs physiologic murmur
- flow is more in childhood and goes away w/ time
- flow is often d/t increased blood flow while physiologic is normal blood flow!!!
flow murmur vs physiologic murmur
- flow is more in childhood and goes away w/ time
- flow is often d/t increased blood flow while physiologic is normal blood flow!!!
all babies with trisomy ____ get an echo
21!
