Congenital Defects Flashcards
What type of congenital defect is a patent ductus arteriosus? What chambers does it affect?
PDA is a persistent foetal vessel causing shunting of blood from the aorta to the pulmonary artery (Left to right). It therefore causes a volume overload on LA/LV (path of shunting erythrocyte).
What type of shunt is caused by a PDA? Is it a volume overload or a pressure overload?
Left to right shunt, causing a volume overload of the left side of the heart.
What location, type of timing of murmur is associated with a PDA?
Continuous murmur dorsal to left heart base, may also have bounding pulses.
Is a PDA manageable? If so, what is the treatment?
Yes - closure of the DA can be done either surgically or with an interventional device.
What type of congenital defect is an aortic stenosis? What chambers does it affect? Is it a volume overload or a pressure overload?
Malformation of the aortic valve and/or LVOT being too narrow at some point. It affects the LV due to a pressure overload (as there is increased resistance to ejection)
What location, type of timing of murmur is associated with an aortic stenosis?
Left heart base systolic murmur, varying intensity based on severity. Poor pulses
Is an aortic stenosis manageable? If so, what is the treatment?
No - patients with severe disease have a very poor prognosis.
What type of congenital defect is an pulmonic stenosis? What chambers does it affect? Is it a volume overload or a pressure overload?
Malformation of the pulmonic valve and/or RVOT being too narrow at some point. It affects the RV due to a pressure overload (as there is increased resistance to ejection)
What location, type of timing of murmur is associated with an pulmonic stenosis?
Left heart base systolic murmur, varying intensity based on severity.
Is a pulmonic stenosis manageable? If so, what is the treatment?
Often manageable - stenosis is often alleviated with a balloon valvuloplasty.
What type of congenital defect is a ventricular septal defect? What chambers does it affect?
Failure of normal formation of interventricular septum. The defect is between the LV and RV, and the blood is shunted left to right. Chambers affected are along the path of the shunted erythrocyte.
What type of shunt is caused by a ventricular septal defect? Is it a volume overload or a pressure overload?
Blood is shunted left to right from LV to RV. There is a volume overload on all structures encountered.
What location, type of timing of murmur is associated with a VSD?
Systolic murmur on right (due to turbulence from left to right). May also have a left systolic murmur due to a pulmonic flow murmur due to an increase in blood being ejected from the RV (LARGE ANIMALS ONLY)
Is a VSD manageable? If so, what is the treatment?
Interventional closure described, but most defects do not require closure. Prognosis is fair.
If there is a bigger VSD, would you expect the murmur to be louder or quieter? Why?
Bigger VSD = quieter murmur. Why? Should be large pressure difference between left and right, but hard to maintain with a VSD, so if a bigger defect, the shunt has less velocity and creates less turbulence.
