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B3. Cardiovascular system > Congenital CV Conditions > Flashcards

Congenital CV Conditions Flashcards

1
Q

Name 9 congenital CV conditiosn

A 
Tetralogy of Fallot
Ventricular Septal Defect (VSD)
Atrial Septal Defect (ASD)
Coarctation of the Aorta
Double Aortic Arch
Transposition of the Great Vessels
Aberrant Subclavian Artery
Patent Ductus Arteriosus
Bicuspid Aortic Valve
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2
Q

What are the 4 characteristics of the tetralogy of fallot

A
  • VSD
  • Aorta overiding the VSD
  • Pulmonary Stenosis
  • Right Ventricular Hypertrophy
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3
Q

What causes the tetralogy of fallot?

A

An abnormality in the seperation of the truncus arteriosus into the aorta & pulmonary trunk

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4
Q

What are the symptoms of the tetralogy of Fallot?

A 
Pulmonary Stenosis Murmur
Cyanosis
Clubbing
RV heave
Small children may show agitation, crying, feeding difficulty, failure to thrive and squatting (they do this because it increases TPR)
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5
Q

How would you investigate tetralogy of fallot/

A

CXR - Boot shaped heart
Echo - Degree of Stenosis
CT/MRI - Helps you plan surgery
FBC - Polycythaemia

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6
Q

What treatments can be given for tetralogy of fallot?

A

O2 and morphine acutely
Surgery to close the VSD and correct the pulmonary stenosis
B-blockers to reduce the strain on the right ventircle in particular

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7
Q

How does a VSD arise non-congenitally?

A

The ventricular septum can rupture in an MI

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8
Q

What are symptoms of VSD?

A

Heave
Systolic Thrill
Pansystolic Murmur
cysanosis & dyspnoea with occasionally severe heart failure

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9
Q

How do we investigate/treat a VSD?

A

An ECG, CXR & Echo

Medical treatment until it closes spontaneously and failing that surgery

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10
Q

In what section of the atrial septum is are ASDs most often found?

A

The upper part or ostium secundum

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11
Q

What are the sympoms/signs of an ASD?

A

Cyanosis - arrhythmia - Haemoptysis - Chest pain - Dyspnoea

Pulmonary Hypertension - High JVP - Pulmonary Ejection Murmur - Atrial Fibrillation

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12
Q

How do we investigate/treat and ASD?

A

ECG - CXR - Echo

Treat with a transcatheter closure or surgical closure

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13
Q

What is coarctation of the aorta>

A

A narrowed Aorta, mainlt on the arch close to the ligamentum arteriosus

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14
Q

What are the signs/symptoms of a coarctated aorta?

A 
Heart Failure - Failure to Thrive
Radial-Radial and Radial-Femoral delay
Weak Femoral Pulse + Cold Legs
Systolic Murmur
Hypotension in lower limbs + ~hypertension above coarctation
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15
Q

What is a double aortic arch?

A

A 2nd arch grows from the ascending aorta and passes behind the trachea & oesophagus before rejoing the left
This can cause difficulty swallowing and breathing

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16
Q

What is transposition of the great vessels:

A

Due to the neural crest cells migrating defectively and the aorticopulmonary septum failing to spiral.
The Aorta feeds off the RV & the Pulmonary trunk off the LV

17
Q

What are the symptoms of great vessel transposition?

A

Cyanosis.
Regularly comes with ASD, VSD & PDA which are needed to keep blood passing between the circulations and the patient alive

18
Q

What is an aberrant subclavian artery:

A

The right 4th aortic arch and dorsal aorta regress abnormally.
So the right subclavian emerges from the aortic arch on your left side & crosses behind the oesophagus to supply the right arm.

19
Q

What is patent ductus arteriosus? (PDA)

A

The ductus arteriosum (connecting aorta & pulmonary trunk) fails to close & become the ligamentum arteriosum after birth

20
Q

What are the symptoms of PDA?

A

Icnreased work of breathing
Poor weight gain
Congestive heart failure as you age

Continuous murmur and large pulse pressure

21
Q

What can a bicuspid aortic valve develop and how can we fix it?

A

Aortic Stenosis
Aortic Regurgitation
Aortic Dissection

Aortic Valve Replacement Surgery

22
Q

How do we investigate and fix a coarctated Aorta?

A

By CXR (rib notching) and CTA or MRA.

We can fix it with bypass surgery or angioplasty + Stenting.

23
Q

What is persistant truncus arteriosus?

A

A failure of the aorticopulmonary septum to form leading to a combined pulm trunk and aorta along with a VSD at their base

24
Q

How does Persistant Truncus Arteriosus present?

A

Cyanosis - HF within weeks - Wide Pulse Pressure - Loud Second Heart Sound - Systolic Ejection Murmur - Pulm Hypertension

25
Q

How do we investigate and treat Persistant truncus arteriosus?

A 
An ECHO and CXR
Surgery:
- Repair VSD
- Add Pulm Artery
- The Truncus Arteriosus becomes the Aorta
26
Q

How do we investigate Transposition of the great vessels?

A

CXR - Egg on a string heart

Echo

27
Q

How do we treat transposition of the great vessels?

A

Surgery

In the mean time prostoglandins to keep the ductus arteriosus from closing

28
Q

How do we investiate and treat PDA?

A

CXR/ECG/ECHO - all show LVH
Surgery if after birth
Prostoglandin synthesis inhibitors if you catch it neonatally or in premature babies

B3. Cardiovascular system (49 decks)

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