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Sys Path > Congenital heart defects > Flashcards

Congenital heart defects Flashcards

1
Q

three shunts in fetal circulation

A
  1. ductus venosus- bypass liver
  2. foramen ovale-move from right to left side of heart
  3. ductus arteriosus- bypass pulmonary
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2
Q

Possibilities of cardiac malformations

A
  1. severe, incompatible with life= embryonic death or fetal abortion
  2. Compatible with intrauterine life, but result in postnatal heart failure or death
  3. Minor malformations which are compensated for and found post mortem or at slaughter
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3
Q

Etiologies of congenital heart failure

A

-genetic
-maternal infections
-nutritional deficiency
-drugs
-teratogens (radiation, fetal hypoxia, maternal diabetes)
-multifactorial (genetic and environmental)

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4
Q

What defects cause volume overload

A
  1. Left to right shunts
  2. Valvular regurgitation from valvular dysplasia
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5
Q

Left to right shunt possibilities

A
  1. Patent ductus arteriosus
  2. Atrial septal defect
  3. Ventricular septal defect
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6
Q

Defects causing pressure overload

A

Aortic and pulmonic stenosis

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7
Q

Defects causing early cyanosis

A

right to left shunts
-tetralogy of fallot
-transposition of great arteries

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8
Q

Patent Ductus Arteriosus (PDA)

A

Normal between pulmonary artery and aorta in fetal circulation.. then becomes ligamentum arteriosum

-Failure seen in dogs, 3 weeks after birth

-Left to right shunt: blood from aorta to pulmonary artery= increased pulmonary blood flow, pulmonary hypertension, pressure overload in RV and volume overload in LV

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9
Q
A

Patent Ductus Arteriosis
-failure to close connection between Aorta and Pulmonary artery

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10
Q

Late cyanosis

A
  1. Occurs with increased pulmonary vascular resistance from left to right shunt leading to medial hypertrophy or irreversible obstructive intimal lesions
  2. shunt will reverse= now going right to left resulting in late cyanosis due to low concentration in blood
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11
Q

Atrial Septal Defect (ASD)

A

Communication between left and right atrium in postnatal life occurring in two ways:
1. Persistence of fetal foramen ovale
2. True atrial defect where atrial septa did not close

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12
Q

Hemodynamis of Atrial Septal Defect

A

Excessive blood flow from LA to RA, results in RV hypertrophy
-pulmonary congestion because oxygenated blood is returning to the lungs

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13
Q
A

Left to Right shunt through patent foramen ovale= Atrial septal defect!

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14
Q

Ventricular Septal Defect

A

Communication between left and right ventricles
-common in domestic animals
-occurs due to failure to connect muscular and membranous septum with infundibulum
-can occur high near AV valve
OR
low near apex (rare)

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15
Q

Hemodynamics of ventricular septal defect

A

Left to right shunt result in increased RV pressure, volume overload, then increased RV hypertrophy and then Right sided heart failure

Then LV hypertrophy, and later reversal to a right to left shunt=cyanosis

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16
Q
A

Ventricular Septal Defect
-left to right shunts, increased volume and hypertension on right side, then hypertrophy and right sided heart failure

17
Q

Valvular dysplasia

A

-congenital malformation; difficult to assess post mortem
-inclues tricuspid dysplasia and mitral dysplasia

18
Q

Tricuspid dysplasia

A

-common in cats, then retriever dogs
-includes one or more of: thickened leaflets, missing or short chordae tendinae, thick or short papillary muscles, fusion of leaflets to papillary muscles or ventricular wall
-causes eccentric hypertrophy of right ventricle and massive distension of right atrium

19
Q

Mitral dysplasia

A

-most common in cats
-includes one or more of: short thick leaflets, short thick chordae tendineae, upward malposition of atrophic or hypertrophic papillary muscles
-causes eccentric hypertrophy of left ventricle and distension of left atrium

20
Q
A

Tricuspid dysplasia
-thick valve

21
Q
A

Tricuspid dysplasia
-short/absent chordae tendineae

22
Q

Pulmonic Stenosis

A

-narrowing or pulmonic valve orifice
-classified as valvular, subvalvular, supravalvular
-also see post-stenotic arterial dilation found in artery distal to stenosis

23
Q

Hemodynamics of pulmonic stenosis

A

Pressure overload in RV leading to RV hypertrophy and if uncompensated, then right sided heart failure

24
Q

Necropsy findings for pulmonic stenosis

A

-broad base heart
-RV hypertrophy
-narrow pulmonary artery lumen due to sub-valvular constrictive fibrosis or fusion of cusps
-pulmonary artery might have post-stenotic dilation

25
Q

Aortic and Subaortic stenosis

A

-common in dogs and pigs
-formed by constricting band of fibrous or muscular tissue encircling the left ventricular outflow tract
-may also see post-stenotic dilation in artery distal to stenosis

26
Q

Hemodynamics or aortic and subaortic stenosis

A

Pressure overload in LV leading to LV hypertrophy, post stenotic dilation of aorta
-if uncompensated can lead to left heart failure and pulmonary edema

27
Q
A

Subaortic stenosis
-post-stenotic dilation of aorta (thin arrow)
-jet lesion (black arrow)
-constricting fibrous tissue (white arrow)

28
Q

Tetralogy of fallot

A
  1. Ventricular septal defect
  2. Overriding aorta
  3. Pulmonic stenosis
  4. Right ventricular hypertrophy
29
Q

Transposition of the great arteries

A

Aorta comes from right ventricle
Pulmonary artery comes from left ventricle

**incompatible with postnatal life unless there is a shunt (right to left shunt)

30
Q

Persistent Right Aortic Arch

A

-most common in dogs
-aorta is incorrectly formed from right fourth rather than left fourth aortic arch in embryo

-trachea and esophagus is enclosed by aortic arch, pulmonary artery and ligamentum arteriosum resulting in esophageal constriction

31
Q

What does esophageal constriction result in?

A

-dysphagia, regurgitation and megaesophagus

-no hemodynamic abnormalities and no signs of heart failure

32
Q
A

Persistent Right Aortic Arch
-flaccid and distended esophagus proximal to ligamentum arteriosum
-entrapped esophagus!

33
Q

Ectopia cordis

A

-mostly found in stillbirths or aborted fetuses
-heart outside the body
-animals can survive for days-weeks

34
Q
A

Ectopia cordia

Sys Path (10 decks)

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