Congenital Heart Defects

Question 1

What is the first flap to grow over the atrium containing two foramens?

and what grows over it?

Answer 1

Septum Prinum

Septum Secundum

Question 2

What is it called when teh Septum Secundum covers the second hole on the septum prinum? What is important about this?

Answer 2

Ostium Secundum

• it acts as a flap

Question 3

What is the most common cause of a patent foramen ovale?

Answer 3

Ostium Secundum

Question 4

In the setting of patent foramen ovale, What is the name of the condition which can occur when the right heart over powers the left heart causing shunting?

Answer 4

Eisenmenger’s syndrome

Question 5

What are the symptoms of patent foramen ovale?

Answer 5

Atrial arrhythmias

Breathless

Body oedema - back up into right heart

Stroke in young person (rare but potentially)

Question 6

What is often associated with Coarctation of the aorta?

Answer 6

Bicupsid valve of the aorta

Question 7

What are clinical findings of coarctation?

Answer 7

LV hypertrophy

Increased blood pressure in upper extremities

increased pressure to brain - berry aneurysm formation

Decreased systolic in lower limbs

Leg claudication

Decreased Renal perfusion - RAAS activation

Rib notching - collateral form between anterior intercostals and posterior intercostals - reversing blood flow.

Question 8

Treatments for coarctation?

Answer 8

End to end graft

Balloon angioplasty

Subclavian flap (old approach,

Question 9

What is it called when there is a cyanotic heart lesion leading to swapping of the great vessels?

Answer 9

Transposition of the great arteries

Question 10

How is transposition of the great arteries treated?

Answer 10

PGE2 infusion when child is first born - maintains the foramens.

Question 11

What is an old treatment of Transposition of the great arteries?

Answer 11

Baffle Operation - creating baffle circulation.

Question 12

What are the issues with Baffle?

Answer 12

Right ventricle becomes systemic circulatory pump

- dilates over time

Question 13

WHats the new operation for Transposition of the arteries?

Answer 13

Atrial swtich
- switch the arteries back

This can disrupt the coronary arteries as they get moved with the aorta. patient prone to M.I

Question 14

What is it called when there are four defects to the heart, and what are they?

Answer 14

Tetralogy of Fallot

1. ventricle septal defect
2. aorta pulled towards right ventricle
3. obstruction to the right ventricle output (reduced blood to lungs)
4. right ventricle hypertrophy

Question 15

Symptoms of tetralogy of falot?

Answer 15

Restricted blood flow to pulmonary arteries

Cynaotic heart diease

Question 16

Treatments of Tetralogy of Falot?

Answer 16

PGE2 at birth

BT shunt

• subclavian moved from aorta to pulmonary - causes shunt
• *will have no right radial blood pressure

complete corrective surgery

Question 17

Uni-ventricular heart?

Answer 17

One functional ventricle.

okay in fetal life which gets Oxygenated blood directly into left ventricle without lung involvement

Question 18

Uni-ventricular treatment?

Answer 18

Fontan circulation

completely by-pass the right heart.

rely on left ventricle to produce enough pressure to force blood through systemic, through right heart, through lungs and back

Question 19

What is the risks of fontan circulation?

Answer 19

anything that impact pulmonary pressure can cause back pressure or reduces systolic pressure.

• P.E
• AF
• Dehydration