Congenital Heart Defects Flashcards
What genetics problems can lead to heart defects?
Downs
Turners
Marfans
What is the term given to something that is harmful in pregnancy?
teratogen
What maternal infections affect foetal cardiac development?
Rubella
Toxoplasmosis
Lots more
How do we get right to left shunts?
Need a hole and an obstruction
Which shunt direction is cyanotic?
Right to left
How is a left to right shunt harmful if it acyanotic?
Pulmonary hypertension is harmful to lungs
List the cyanotic heart defects that involve shunts?
Atrio-Septal Defects
Ventriculo-Septal Defect
Patent Ductus Arteriosusm
What obstructive lesions in cardiac development can cause acyanotic defect?
Aotric stenosis
Pulmonary stenosis
Coarctation of the aorta (narrowing of the aorta at the level of the ligamentum arteriosum)
Mitral stenosis
What does the ductus arteriosum develop in to after birth?
Ligamentum arteriosum.
Is tetralogy of fallow cyanotic or not and why?
Cyanotic- 4 defects involving a hole and an obstruction. Over-riding aorta RVH Huge septal defect Pulmonary stenosis
Transposition of the great arteries is where the great vessels connect to the wrong side of the heart, does this cause cyanosis?
Yes- the right and left heart are no longer connected the right is only pumping systemically and the left is the only pulmonary circulation- so with no shunt we only have deoxygenated blood in systemic circulation
Why is a univentricular heart cyanotic?
Mixing ox deoxygenated blood an oxygenated blood entering the aorta for systemic circulation.
What is total anomalous pulmonary venous drainage?
The pulmonary trunk return to RA not LA. Left side of heart has no blood pumping at all- not compatible with life. Most exist with an Atrial Septal Defect as well.
What are the haemodynamic effects of an atrial septal defect?
L--> R shunt Increased pulmonary flow RV overloaded Pulmonary hypertension- rare Right sided heart failure Atrial arrhythmias may occur
Which chamber gets over loaded in a ventricular septal defect?
Left ventricle
R–>L shunt means the first ventricle to get the larger blood volume is the left.
What pulmonary side effects may arise from a ventricular petal defect?
Pulmonary hypertension
Pulmonary venous congestion.
What septal defect is associated with Downs?
Atrio0ventricular septal defect (both at once giving left to right shunt)
What is tricuspid atresia?
No tricuspid valve to let blood flow from RA to RV.
R->L shunt of entire venous return
Only way blood gets to lungs is if patent ductus arteriosum or a ventriclar septal defect
CYANOTIC
Outline the pathology in left heart hypoplasia.
Left ventricle under developed
Ascending aorta is thus small.
Right ventricle supports systemic circulation via the obligatory R->L shunt
Is great vessel transposition viable?
Not unless the two circuits communicate- bidirectional shunting
What must be protected in univentricular heart?
Pulmonary circulation (should be a low pressure system)
Whats pulmonary atresia?
No RV outlet.
R–> L atrial shunt (ASD)
Blood has to flow to lungs by a patent DA.
When are ASDs normally picked up and what are the complications?
Late into adulthood.
Arrhythmia and Right heart failure
Ventricular septal defects are picked up in infancy, what is the presentation and whats the serious consequence?
Present with left side heart failure
If interest may develop inoperable pulmonary hypertension
Congenital coarctation of the aorta is associate with which shunt type?
R–>L from a PDA
Coarctation of the aorta in an adult can lead to what 2 conditions and is often associated with what?
Associated with aortic valve stenosis
Leads to Left ventricular hypertrophy and renal hypertension
If a child has mild tetralogy of fallow what might they experience and is it viable?
If very mild viable with cyanotic spells
How do transpositions, hypo plastic LH, preductal coarctations and pulmonary atresia present?
Neonatal emergency with reduced pulmonary flow.
