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echo > Congenital Disease > Flashcards

Congenital Disease Flashcards

1
Q

ASD echo

A

RV enlargement
TR, pHTN
Color flow for shunt
Looks at PVs

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2
Q

Secundum ASD

A

Most common
Central / fossa ovalis
Device closure
Associated with Holt-Oram

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3
Q

Primum ASD

A

AV septum / inlet to ventricle

Portion of septum between septal TV leaflet and anterior MV leaflet

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4
Q

Primum ASD echo

A

Cleft mitral valve anterior leaflet, MR
LVOT obstruction (enlongated outflow tract, accessory chordal tissue)
VSD
LAD on EKG

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5
Q

Sinus venous ASD

A

Abnormal communication between SVC, pulmonary vein and LA
Anomolous PVs in most
Big right heart

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6
Q

Unroofed coronary sinus

A

Absence of portion of common wall between CS and LA

A/W persistent left SVC

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7
Q

PFO

A

Potential opening between RA and LA

Does not cause RV volume overload

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8
Q

Atrial septal aneurysm

A

Redundant and mobile atrial septum flap
Phasic excursion of 10 mm from midline or total of 15 mm during cardiac cycle
A/w PFO or multiple fenestrations

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9
Q

Chiari network

A

Meshwork connecting edge of IVC and coronary sinus with Crista terminalis
A/W PFO and ASA

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10
Q

VSD

A

Left to right shunt

Causes left heart dilatation

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11
Q

Types of VSD

A

Outlet / sub arterial
Membranous
Inlet
Muscular

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12
Q

Outlet / sub arterial VSD

A

Located in outlet septum
Under PV and AV
AR due to prolapse of AV cusps

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13
Q

Membranous VSD

A

Between TV and AV
Most common
TV may become aneurysmal
AR

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14
Q

Inlet VSD

A

At inlet to ventricle (AV septal defect)
Immediately below both AV valves
Trisomy 21

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15
Q

Muscular VSD

A

Muscular portion of septum
Children
Not near valves, close with device
Apical 4, parasternal views

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16
Q

VSD in PLAX

A

Right below AV = membranous or subarterial

Further out = muscular

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17
Q

VSD in RV inflow/outflow SAX

A 
9-12:00 = membranous
12-3 = subarterial
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18
Q

VSD in LV SAX

A 
9-11 = inlet
11-2 = muscular
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19
Q

VSD apical 4

A

Base of septum = inlet

Rest of septum = muscular

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20
Q

VSD in apical 5

A

Base of septum = membranous

Rest of septum = muscular

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21
Q

RVSP using VSD velocity

A

RVSP = SBP - 4 (VSD vel^2)

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22
Q

PDA characteristics

A

Communication between descending thoracic aorta and PA

Left heart enlargement

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23
Q

PDA echo

A 
High left parasternal or SSN
Color and CW doppler across PDA
LV enlargement
Holodiastolic flow reversal in abdominal aorta
pHTN
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24
Q

PASP in PDA

A

PASP = SBP - 4 (PDAv^2)

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25
Q

Ebstein’s anomaly

A

Exaggerated apical displacement of TV septal leaflet
Atiralized RV, RV dysfunction
ASD / PFO
Accessory pathway
Rotational displacement of TV towards RVOT
Sail like and large anterior TV leaflet

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26
Q

Indexed apical displacement of TV septal leaflet in Ebstein’s

A

> 8 mm/m2

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27
Q

Tetralogy of Fallot

A 
Displacement of part of ventricular septum ->
RVOT obstruction
Secondary RV hypertrophy
VSD
Associated aortic override
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28
Q

ToF associated with

A

Right aortic arch
Secundum ASD
Anomalous coronary arteries

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29
Q

Problems after ToF repair

A

PR due to patch in RVOT
PS
Residual VSD
AR

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30
Q

Coarctation aorta PW doppler

A

Later upstroke in systole

Persistent flow in diastole

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31
Q

Coarctation echo

A

Dilated ascending aorta
BAV
Abnormal aorta PW doppler

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32
Q

d-loop TGA

A

RV is on right side

33
Q

l-loop TGA

A

Morphologic RV with TV is on left side

34
Q

Congenitally-corrected TGA echo

A

RV with coarse trabeculation, septoparietxal muscle bundle, TV chordal insertions into RV
TV apical compared to MV

35
Q

Cardiac crux

A

Meeting between AV septum and septal portion of MV and TV

Inflow portion of LV and RV

36
Q

Corrected TGA a/w

A 
Systemic TR
Decreased ventricular function
VSD, PS, RV dysfunction
Dextrocardia, mesocardia
CHB
37
Q

Heart on fire

A

Anomalous RCA from pulmonary artery

38
Q

Blalock-Taussig shunt

A

Subclavian artery transected, connected to pulmonary artery

39
Q

Surgical shunts

A

For cyanotic patients with low pulmonary blood flow

40
Q

Echo in Blalock-Taussig Shunt

A

High velocity signal, continuous flow in diastole

41
Q

Classic Glenn Shunt

A

SVC to PA connection

Low velocity flow (venous)

42
Q

Bidirectional Glenn shunt

A

SVC to both PAs

43
Q

Problems with shunts

A

PA distortion

pHTN, LV volume overload with large shunts

44
Q

Baffles

A

Typically for transposition

45
Q

Atrial switch baffle (mustard, senning)

A

IVC / SVC -> LV -> lungs

-> Pulmonary venous baffle -> RV -> body

46
Q

Atrial switch echo

A

Redirection of PV blood to morphologic RV to body

LV connected to PA

47
Q

Rastelli shunt

A

When VSD present
LV -> aorta
RV -> pa conduit

48
Q

Arterial switch

A

Transect both great vessels, redirects them

Reimplants coronary arteries

49
Q

ToF most common post op problem

A

PR

50
Q

l-TGA correction problems

A

Systemic TR
Systemic RV dysfunction
CHB

51
Q

d-TGA corrected problems

A

RV dysfunction
Arrhythmias
Baffle problems

52
Q

Arterial switch problems

A

Valve and vessel (CA) problems

53
Q

Rastelli problems

A

Subaortic stenosis

Conduit obstruction

54
Q

Big RV DDx

A

ASD or PV shunt
TR and PR
RV myopathy
Systemic RV

55
Q

VSD leads to enlargement of

A

LV

56
Q

ASD leads to enlargement of

A

RV / RA

57
Q

Best view for ASD

A

Subcostal 4-chamber

58
Q

Trisomy 21 a/w

A

AV septal defect

ToF

59
Q

Best view for sub pulmonary VSD

A

Parasternal short axis

60
Q

Large VSD physiology effect

A

Equalization of right and left ventricular pressures
Elevated PA pressure
Left atrial and ventricular volume overload

61
Q

Most common type of subaortic stenosis

A

Discrete membrane

62
Q

VSD associated with coarctation

A

Perimembranous VSD

63
Q

Aortic arch interruption most common in

A

DiGeorge syndrome

64
Q

Type A interruption of aortic arch

A

Distal to origin of left subclavian

65
Q

Type B interruption of aortic arch

A

Between left common carotid and left subclavian artery

66
Q

Type C interruption of aortic arch

A

Between right innominate and left common carotid arteries

67
Q

Muscular VSD spontaneous closure rate in childhood

A

80-90%

68
Q

Direction of atrial shunting determined by

A

Compliance of ventricles

69
Q

Most common site of coarctation

A

Opposite insertion site of ductus arteriosus

70
Q

Noonan syndrome

A

Short stature, triangular face, webbed neck
PV stenosis
HCM
ASDs

71
Q

Most common cyanotic CHD

A

ToF

72
Q

Truncus arteriosus

A

Large VSD
Overriding great vessel
Single great vessel giving rise to aorta and PA
A/w DiGeorge syndrome

73
Q

Tricuspid valve atresia

A

Must have atrial shunt to decompress RA
25% have transposition
Single ventricle lesion; lateral Fontan connects IVC to PA

74
Q

Hypoplastic left heart syndrome

A

Two atria. single ventricle, single AV valve
Ductal dependent
CO maintained by circumventing left heart

75
Q

Pulmonary atresia with intact ventricular septum

A

RV hypoplasia

Needs to repair as single ventricle

76
Q

Pulmonary atresia with VSD

A

Severe form of ToF

77
Q

Total anomalous pulmonary venous return

A

PVs converge in midline, posterior and superior to LA

See pulmonary venous confluence

78
Q

TGA most commonly a/w

A

VSD

echo (30 decks)

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