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2 - Sarah's CVS > Congenital Heart Defects > Flashcards

Congenital Heart Defects Flashcards

1
Q

Define ventricular septal defects

A

An abnormal opening in the interventricular septum

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2
Q

Describe ventricular septal defects

A

– usually occurs in the membranous portion of the septum

  • BLOOD FLOW from left to right due to pressure gradient – acyanotic

– 25% of all congenital heart defects

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3
Q

What can ventricular septal defects cause?

A
  1. LV hypertrophy as LV volume is overloaded
  2. Pulmonary hypertension after pulmonary venous congestion
  3. Pneumothorax
  4. Dyspnoea
  5. Pulmonary oedema
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4
Q

Define atrial septal defect

A

An abnormal opening in the septum between the two atria which persists following birth

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5
Q

Describe atrial septal defect

A

Foramen ovale fails to close in majority of cases

Causes L to R flow – acyanotic

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6
Q

Define patent foramen ovale

A

Foramen ovale fails to close properly

– higher LA pressure tends to close gap so patients are asymptomatic

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7
Q

What are the four anomalies found in tetralogy of fallout?

A

Ventricular septal defect
Overriding aorta
Pulmonary stenosis
Right ventricular hypertrophy

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8
Q

What are the main effects of tetralogy of fallot?

What determines the severity?

A

Pulmonary stenosis – persistent right ventricular hypertrophy as higher pressure os needed to pump blood
Cyanosis due to VSD and OA causing R to L shunting.

Severity of pulmonary stenosis

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9
Q

What are the symptoms of tetralogy of fallot?

A 
Low blood O2
Difficulty with eating
Failure to weight gain
Retarded growth
"Tet spells" -- marked increase in cyanosis followed by syncope. Can cause brain injurt and death
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10
Q

Define tricuspid atresia

A

Lack of development of the tricuspid valve so there is no inlet into the right ventricle

    • R to L atrial shunt
    • Ventricular septal defect allows flow to lungs
    • is incurable as can’t replace ventricles
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11
Q

Define transposition of the great arteries and give its cause

A

Two unconnected parallel circuits instead of one

Caused by conotruncal septum not adopting a spiral course

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12
Q

Describe transposition of the great arteries

A

RV connected to aorta. LV connected to pulmonary artery
– causes major cyanosis
(deoxygenated blood continues in systemic circulation and oxygenated blood continues in pulmonary circulation)

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13
Q

What is the treatment for transposition of the great arteries?

A
    • need communication as fetus will not be viable

- - surgery is required straight after birth

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14
Q

Define total anomalous pulmonary venous drainage

A

ll 4 pulmonary veins drain into the vena cava or the right atrium causing systemic and venous blood to mix in the right atrium.

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15
Q

What is univentricular heart?

A

Both the atria drain into one ventricle.

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16
Q

What is hypoplastic left heart?

A

LV and ascending aorta fail to develop properly.

Is lethal without surgery

17
Q

What does hypoplastic left heart cause?

A

Underdeveloped left ventricle
Small ascending aorta
RV supports the systemic circulation via patent foramen ovale or atrial septal defect

18
Q

Define stenosis

A

abnormal narrowing of a blood vessel

19
Q

Define atresia

A

absence of abnormal closure of blood vessel

20
Q

What is aortic stenosis?

A

Abnormal narrowing of aortic valve

21
Q

What are the effects of aortic stenosis?

A

Valve leaflets are stiff, leads to reduced systolic opening and increased left ventricular pressure.

22
Q

What are the symptoms of aortic stenosis?

A

Exercise induced angina
Syncope
Heart failure – due to ischaemia of LV myocardium

23
Q

Define aortic atresia

A

no left ventricular outlet causing impeded blood flow. The only source of blood flow is via a patent ductus arteriosus

24
Q

Define pulmonary stenosis

A

Abnormal narrowing of pulmonary valve

25
Q

What are the effects of pulmonary stenosis?

What causes it?

A

– RV systole is obstructed, so RV and RA become hypertrophied

– tends to be due to a congenital lesion (rubella)

26
Q

What are some symptoms of pulmonary stenosis?

A

fatigue, syncope and right heart failure

27
Q

Define pulmonary atresia

A

No right ventricular outlet is present

28
Q

What are the effects of pulmonary atresia?

A

–R to L shunt of the entire venous system and blood flow to the lungs occurs via a patent ductus arteriosus

29
Q

Define patent ductus arteriosus

A

Ductus arteriosus does not close and is present after birth.
– connects pulmonary artery to the aorta in the fetus

30
Q

When should the ductus arteriosus close?

A

After birth, when the lungs receive oxygen and the pressure in the pulmonary artery drops

31
Q

What are the effects of a patent ductus arteriosus?

A

Causes L to R shunt
– large shunt can lead to pulmonary hypertension, vascular remodelling of the pulmonary circulation and increased pulmonary resistance.

32
Q

Define Eisenmenger syndrome

A

Increased pulmonary resistance can lead to the shunt reversing if pressure is greater than systemic pressure

33
Q

Define coarctation of the aorta

A

Is a narrowing of the aortic lumen where the ductus arteriosus inserts.

34
Q

What are the effects of coarctation of the aorta?

A
    • Increases the after load (tension developed in the wall) of the LV
    • Causes left ventricular hypertrophy (heart has to pump harder to reach the same outflow)
    • Blood flow to lower body and trunk is reduced (vessels emerge from heart distal to coarctation)
    • Blood flow to head and neck not affected as they leave proximal to coarctation.
35
Q

What are the symptoms of coarctation of the aorta?

A
    • babies can be born with signs of heart failure in severe cases.
    • mild cases can be detected in adult life.
    • femoral pulses are weak and delayed and there will be upper body hypertension.

2 - Sarah's CVS (13 decks)

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