Congenital Heart Defects (The Bare Minimum) Flashcards
type of murmur in PDA?
continuous “machine like” murmur
loudest under left clavicle
other presenting features of PDA?
often asymptomatic if small and can close spontaneously
generally doesnt cause cyanosis but can do eventually if not corrected
can be asymptomatic until adulthood then cause heart failure
symptoms include:
- SOB
- difficulty feeding
- poor weight gain
- LRTI
diagnosis of PDA?
ECHO
doppler during ECHO can assess size of shunt
how is PDA managed if symptomatic?
NSAIDs can close PDA pharmacologically (eg ibuprofen or indomethacin)
if associated with another congenital heart defect amenable to surgery then prostaglandin E1 is useful to keep duct open until surgery
how is asymptomatic PDA managed?
can be monitored up to 1 year old and see if it closes on its own
if it hasnt closed by 1 year then its closed surgically
most likely congenital heart defect to be found in adulthood?
ASD
examination features in ASD?
can be asymptomatic
ejection mid-systolic murmur heart best at upper left sternal border
fixed split second heart sound (S2)
2 types of ASD?
ostium primum ostium secundum (70% of ASDs,)
ECG features of ostium primum?
RBBB with LAD
prolonged PR interval
ECG features of osttium secundum?
RBBB with RAD
presenting symptoms of ASD in children?
SOB
difficulty feeding
poor weight gain
LRTI
presnting symptoms of ASD in adults?
heart failure
dyspnoea
stroke
complications of ASD?
stroke (DVT becomes an embolus and travels to right side of heart, through ASD to left side then up to brain)
AF
atrial flutter
pulmonary hypertnesion and right sided heart failure (blood shunted from left to right causing increased pressure on right side)
eisenmenger syndrome
what is eisenmenger syndrome?
where pressure builds up so much in right side of heart that the pressure becomes higher than the left side so the shunt changes from left > right to right >left
how is ASD managed?
can watch and wait if small and asymptomatic
can be surgically corrected via transvenous catheter closure or open heart surgery
anticoagulants/antiplatelets used in adults to reduce stroke risk
what syndrome is associated with ASD?
downs
also associated with atrioventricular septal defect