Congenital heart disease

Question 1

Cardiac tube

Answer 1

-rectilinear
- 4 craniocaudally dilations ;
1.Bulbus cordis
2.prmitive ventricle
3.primitive atrium
4.venous sinus
with 2 additional trunks - right and left

Question 2

from arterial extremity 2 ___ emerge and towards the __(2),(3),(4) come together in each trunk of the venous sinus

Answer 2

(1) ventral aortas
(2) vitelline
(3) umbilical
(4) common cardiac veins

Question 3

Cardiac septation takes place during days

Answer 3

27-36 of

gestation, for atria and ventricles simultaneously.

Question 4

Septation of the primitive atrium and the

atrioventricular canal

Answer 4

The first process which precedes septation of the
primitive atrium is the occurrence of septum
intermedium, which is formed during the fusion of two
endocardial cushions on the anterior and posterior side
of the atrioventricular canal. It will be divided into two
atrioventricular ostia – right and left.

Question 5

Formation of septum primum –

Answer 5

an endocardial crease from the
superior wall of the primitive atrium, which tends to fuse with septum intermedium. There is a temporary orifice which persists at the inferior part of the septum primum and facilitates communication bewteen the future right and left atria – foramen primum

Question 6

Foramen secundum

Answer 6

emerges at the
superior part of the
septum after the
obliteration of
foramen primum.

At the right side of
septum primum, from
the roof of the right
atrium emerges
septum secundum,
incompletely formed,
with an inferior
concave margin
which will limit
among with foramen
secundum an oblique
orifice between the
two atria – foramen
ovale.

Question 7

Spiral septum

Answer 7

originates from the fusion of two
endocardial plications (bulbar crests), from the lumen
of the arterial bulb. It will separate the heart tube bulb
into the right ventricular infundibulum and the left
ventricle aortic vestibule.

Cranially, the spiral septum forms the
aorticopulmonary septum that divides the primitive
arterial trunk into the pulmonary trunk (anterior) and
the ascending aorta (posterior).

Question 8

Abnormalities and malformations in the

development of the heart

Answer 8

1.Position abnormalities: ectopic heart (in the cervical region or outside the thorax), dextrocardia

2. Atrial septal defect – from the persistence of an orifice at the level of foramen secundum to the total absence of the septum (cor triatriatum – with a single atrium); 15-20% of adults may have an interatrial communication in the upper part of the oval
   fossa, the size of a catheter, without hemodynamic
   consequences.

Question 9

Tetralogy of Fallot

Answer 9

incorrect septation of the arterial
trunk due to abnormal evolution of the spiral septum:

• pulmonary trunk stenosis
• aorta overriding the septum receives blood from
  both vetricles
• right ventricular hypertrophy
• defect septal interventricular

Question 10

Transposition of large vessels

Answer 10

anomaly in the
evolution of spiral septum

• aorta will originate in the right ventricle
• pulmonary trunk will originate in the left ventricle
• associated with interventricular septal defect
• Pulmonary valvular stenoses and atresias

Aortic valvular stenoses and atresias

Question 11

Persistence of the arterial duct (Botalo)

Answer 11

normally
fibrotic during the first 3 months after birth, forms the
arterial ligament. It is located between the left
pulmonary artery and the aortic arch; shortcuts
non-functional pulmonary circulation during intrauterine
life

Question 12

Aortic coartation

Answer 12

considerable narrowing of the
lumen of pre or postductal aorta (superior or inferior to
the arterial duct)

Question 13

SHUNTS

Definition:

Answer 13

abnormal
communications between
homologous cavities (LA→RA,
LV→RV) or between different
cavities (Ao→LA)

Question 14

Injection pressure:

Answer 14

high (LV → RV)

low (LA → RA)

consequence: flow inequality
between systemic and pulmonary
circulation