congenital heart defects

Question 1

distinguish enlargement and dilation

Answer 1

dilation is associated with failure

Question 2

Name four types of ASD

Answer 2

Fossa ovalis (secundum),
Primum type
Sinus venosus or proximal
Coronary Sinus

Question 3

pathological effects of ASD

Answer 3

hypertrophy of RA,RV and dilatation of tricuspid and pulmonary orifices with elevated pulmonary flow

Question 4

cause and effect of ASD primum type

Answer 4

defect distal to fossa ovalis. failure of endocardial cushions to fuse. you get anterior mitral leaflet malformation eventually leading to regurg. RA, RV hypertrophied and dilated. LV hypertrophy due to regurg

Question 5

VSD

Answer 5

usually of the subaortic, in part membranous in part muscular type. Dilatation and hypertrophy of RV, LV, LA and hypertrophy of RA. Dilatation of pulm orifice and trunk.

Question 6

PDA

Answer 6

distal to isthmus. Volume hypertrophy of LA and LV. increased pulm flow.

Question 7

describe the course of pulm htn associated with shunts

Answer 7

pulm htn leads to right side hypertrophy and possible volume atrophy of left side followed by reversal of shunt (eisenmengers) Large VSD>PDA>ASD

Question 8

How much narrowing is needed to get pathologic effects

Answer 8

> 65%

Question 9

where does pulm stenosis usually happen

Answer 9

valvular and/or infundibular. Often accompanied by post-stenotic dilatation of pulm art

Question 10

what changes do we see in aortic stenosis

Answer 10

LV hypertrophy, often with smaller LV than normal

Question 11

dynamics of adult coarctation

Answer 11

LV hypertrophy. increased BP in arms, decreased in legs

Question 12

dynamics of fetal coarctation

Answer 12

RA,RV hypertrophied and dilated. LA,LV atrophied. dilatation of PA, hypoplasia of Ao. Left to right ASD, RIght to left PDA. Caused by lack of fetal flow to left side. Cyanosis of lower extremities

Question 13

describe VSD in tetrology of fallot

Answer 13

U shaped