Congenital heart disease Flashcards
Three risk factors for congenital heart disease?
genetic gestational diabetes drugs during pregnancy infections alcohol smoking
What is the presentation of congenital heart disease?
hypoxia tachyopnoea tachycardia cyanosis poor weight gain failure to thrive
Which murmur does atrial septal defect result in?
soft ejection systolic murmur at upper left sternal border
Which conditions are ventricular septal defect associated with?
down’s syndrome
edward’s syndrome
patau’s syndrome
Which murmur is associated with ventricular septal defect?
systolic murmur lower left sternal edge
Which shunt is present in ventricular septal defect?
left to right but can reverse if pulmonary hypertension occurs
Which abnormality is present in coarctation of the aorta?
narrowing of aorta distal to the origin of the left subclavian vein
Which condition is coarctation of the aorta associated with that might leave you prone to haemorrhage?
berry aneurysm
Name one key sign of coarctation of the aorta
radio-femoral delay
What happens to the blood pressure and appearance of skin colour in coarctation of the aorta?
BP higher in upper limbs vs lower
upper body pink vs lower body cyanosed
Which condition is patent ductus arteriosus associated with?
down’s syndrome
What are the four features of tetralogy of fallot?
VSD
Overriding aorta
pulmonary stenosis
right ventricular hypertrophy
Which is the most common congenital heart condition?
congenital bicuspid aortic valve
Which genetic condition is bicuspid aortic valve associated with?
turner’s syndrome
Which murmur is present with coarctation of the aorta?
systolic murmur in left infraclavicular area
Which murmur is present in patent ductus arteriosus?
continuous machinery murmur at upper left sternal border
What is Eisenmenger’s syndrome?
obstructive pulmonary vascular disease causing pulmonary hypertension, right to left shunt
What are the signs of Eisenmenger’s syndrome?
dyspnoea syncope cyanosis finger clubbing right ventricular heave
Which heart sound is present in Eisenmenger’s syndrome?
loud second heart sound with narrow split
What is the management of Eisenmenger’s syndrome?
- avoid smoking, dehydration, pregnancy, excessive physical activity
- treat HF
- treat arrhythmias
- heart/lung transplant
Why does polycythaemia vera arise in Eisenmenger’s syndrome?
in response to the right to left shunt causing poor oxygenation of RBCs leading to cyanosis. In response, the bone marrow produces more RBCs and Hb to correct this imbalance. This leads to a high concentration of Hb in the blood.
Why are people with Eisenmenger’s syndrome prone to cerebrovascular events?
the high concentration of Hb causes blood to become more viscous
Which lesions of the heart are associated with Eisenmenger’s syndrome?
Atrial septal defect
Ventricular septal defect
Patent ductus arteriosus
How is polcythaemia treated in Eisenmenger’s syndrome?
venesection
