Congenital Heart Defects Flashcards
What are the causes of congenital heart defects?
Maternal infections
Environmental factors
Genetic factors
What kinds of maternal infections can cause CHDs?
Rubella, toxoplasmosis
What kinds of environmental factors can cause CHDs?
Teratogenicity from drugs, alcohol
What kinds of genetic factors can cause CHDs?
Turners (XO)
Downs syndrome (trisomy 21)
Marfans syndromes
What are the two major classifications of CHD?
Acyanotic
Cyanotic
What are the two types of acyanotic CHDs?
Obstructive lesions
Left to right shunts
What are the different types of obstructive lesions?
Pulmonary stenosis
Aortic stenosis
Coarctation of the aorta (narrowing)- collateral circulation can bypass
Mitral stenosis
What kinds of left to right shunts are there?
Atrioventricular
ASD
PDA
VSD
What is the effect of ASD?
Blood moves from left to right- increased pulmonary blood flow- p.hypertension is rare
RV volume overload- eventual right heart failure will occur
Natural history- asymptomatic late into childhood- late onset arrythmia and right heart failure
What will happen in a VSD?
Blood moves from left to right
The now circulating blood causes LV volume overload, pulmonary venous congestion and eventual pulmonary hypertension
Patients present in infancy with left heart failure
What are the different types of cyanotic CHD?
Univentricular heart Transposition of the great arteries Total anomalous pulmonary venous drainage Tetralogy of fallot Tricuspid atresia Pulmonary atresia Hypoplastic left heart
What is the problem with a univentricular heart?
The pulmonary circulation is directly exposed to the power of the left ventricle so lung damage occurs
Why is transposition of the great arteries dangerous?
Not viable for life outside of utero
Right ventricle connected to aorta and left ventricle connected to PA so separate circulations only connected by fetal circulatory shunts
What are the four characteristics of tetralogy of fallot?
Right ventricular hypertrophy
Overriding aorta
Pulmonary stenosis
VSD
Tricuspid atresia
No RV inlet
All blood is pumped to lungs by obligatory fetal shunt
