Congenital Heart Disease Flashcards by Iseoluwa Ojo

Congenital heart disease

This is a general term used to describe _______ of the _____ or ______ that are present from _____

abnormalities

heart or great vessels

birth

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Congenital heart disease

• Usually arises from faulty embryogenesis during the ____ week of gestation (max ____ week)

3rd

5th

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Congenital heart disease

few are associated with live birth

T/F

Most are associated with live birth

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Congenital heart disease

some are not compartible with intrauterine survival

T/F

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AETIOLOGY of congenital heart disease
•____% unknown

•__________ ,with genetic and environmental factors playing a part

• associated with chromosomal disorders such as ——— and ______ syndrome

Multifactorial

Downs and Turners

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AETIOLOGY of congenital heart disease

• Infection such as _______
• Hypoxia
•__________
•_______ exposure to mother (especially between __-__ week)

Rubella

Thalidomide

Radiation

3-8

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SHUNTS- These are __________ between the chambers or blood vessels;
• -left to right shunts
• -right to left shunts

abnormal communications

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Initial left to right shunt
• - ____
• -_____
• __________________
• -APVD
• ______________ SYNDROME

• Right to left shunt
• -______
• -____

ASD; PDA

PERSISTENT TRUNCUS ARTERIOSUS (PTA)

HYPOPLASTIC LEFT HEART

TOF; TA

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What congenital heart defect has the highest Relative Incidence

VSD

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ATRIAL SEPTAL DEFECT
• ASD refers to an abnormal opening in ________ allowing communication of blood between the ________ and _______

atrial septum

right and left atrium

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ATRIAL SEPTAL DEFECT is the same as a patent foramen ovale which occurs in about ___% of normal individuals

T/F

different from a patent foramen ovale

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ATRIAL SEPTAL DEFECT

• There 3 main types ;

• - _______ type
• -_________ type ASD
• -___________ type

sceundum

primum

sinus venosus

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ATRIAL SEPTAL DEFECT

• There 3 main types ;

• -sceundum type ,located _______
• -primum typeASD, _________
• -sinus venosus type, near the ———

highup

lowerdown

SA node

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ATRIAL SEPTAL DEFECT: Secundum type ASD

•_____ % of all ASDs
• Results from defiency or fenestration of the ___________,__________, or _________

embryonic septum primum, deficiency of septum secundum or both

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ATRIAL SEPTAL DEFECT: Secundum type ASD

• Aperture may be _____,_______, or_______

• Larger defect creates a ________

single, multiple or fenestrated

single atrial chamber

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ATRIAL SEPTAL DEFECT: Primum type ASD

• ____% of all ASDs

• Occurs (low or high?) in the atrium

Low

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ATRIAL SEPTAL DEFECT: Primum type ASD

• (Antero or Posterò?) -(inferior or superior ?) to the fossa ovalis and adjacent to the ________

Antero ; inferior

AV node

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ATRIAL SEPTAL DEFECT: Primum type ASD

• associated with ___________ leaflet and can be associated with _______ defect

left anterior mitral

partial AV

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ATRIAL SEPTAL DEFECT: Sinus venosus

•___% of all ASDs

• Located (low or high ?) in atrial septum, near _______ which may saddle it

High

entrance of SVC

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ATRIAL SEPTAL DEFECT: Sinus venosus

• Associated with anomalous connections of ______________ to the right atrium

right pulmonary veins

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ATRIAL SEPTAL DEFECT: Clinical features

•_____ to ______ shunt

• Initially (cyanotic or acyanotic?)

• Increased _______ blood flow

Left to right

Acyanotic

pulmonary

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ATRIAL SEPTAL DEFECT: Clinical features

• Small ASDs are (poorly or well?) tolerated, (asymptomatic or symptomatic?)

•Large ASDs usually manifest around age ____

• _________ is a late consequence because the ________________________

Well; asymptomatic

Pulmonary hypertension

lungs cant tolerate increased blood flow

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ATRIAL SEPTAL DEFECT: Clinical features

• When pulmonary hypertension occurs, it results in
• - _______
• -_______ difficulty
• -________ failure
•__________ is rare
•_________ embolus or _______ occurs when blood flow is reversed

cyanosis

respiratory

Cardiac

Infective endocarditis; Paradoxical

brain abscess

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__________ is the most common congenital anomaly

VENTRICULAR SEPTAL DEFECT

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VENTRICULAR SEPTAL DEFECT It is associated with other anomalies •_____% are isolated • It may present at birth, later in life or in adulthood

VENTRICULAR SEPTAL DEFECT • It may be • - ________(___%),and (single or multiple?) • - __________(____%)

muscular; 10; multiple membranous;90

Ventricular septal defect Functional severity depends on the _____ and presence or absence of _______

size pulmonary stenosis

VENTRICULAR SEPTAL DEFECT: Small defects • are ‘ ________ ’ •____% close spontaneously • are (poorly or well?) tolerated

muscular 50 Well

VENTRICULAR SEPTAL DEFECT •____________ and _________ are present from birth • Small defects produce ________ and predisposition to ________

Right ventricular hypertrophy and pulmonary hypertension jet streams infective endocarditis

PATENT DUCTUS ARTERIOSUS • This occurs when the normal _________ channels during intra-uterine life remains open after birth

aorto-pulmonary vascular

PATENT DUCTUS ARTERIOSUS • Increased ______ after birth and changes in _____ contribute to the constriction and closing of the DA, normally

oxygen tension Prostaglandin

PATENT DUCTUS ARTERIOSUS • After birth, it may remain open, especially in ______ babies due to ________ •___-___% are isolated, others have ____

premature low oxygen levels 85-90; VSD

PATENT DUCTUS ARTERIOSUS: Clinical presentation • Presents with a _______(____) murmur • (Acyanosis or Cyanosis?) initially

machinery (pan systolic) Acyanosis

PATENT DUCTUS ARTERIOSUS: Clinical presentation eventual Pulmonary hypertension with reversal of shunt , leading to: •_______,________,______ •____________ failure

Cyanosis, finger clubbing, polycythaemia Right ventricular

PATENT DUCTUS ARTERIOSUS • Clinical presentation • Acyanotic heart disease is converted to cyanotic heart disease because ________________________ which ought not to be so.

the pulmonary tension is higher than the systemic tension

PATENT DUCTUS ARTERIOSUS • Clinical presentation • Red blood cells are produced in increased amount because ______________ leading to polycythaemia

the body senses hypoxia

PATENT DUCTUS ARTERIOSUS • Clinical presentation • Right ventricular ______ over time leads to ______ which causes heart failure

hypertrophy dilation

ATRIOVENTRICULAR SEPTAL DEFECT • Failure of fusion of the ___________________________ results in (complete or incomplete?) closure of the _______ and the inadequate formation of the ____________ and __________ leaflets

superior and inferior endocardial cushions Incomplete ; AV septum septal tricuspid and anterior mitral

ATRIOVENTRICULAR SEPTAL DEFECT • The commonest abnormality is • -_____ AV septal defects • -_______ AV septal defect and a ________

partial complete; large common AV valve

ATRIOVENTRICULAR SEPTAL DEFECT: Partial AV septal defects •involves ________ and _____________ • Causing ______ insufficiency

Primum ASD and left anterior mitral leaflet mitral valve

ATRIOVENTRICULAR SEPTAL DEFECT: Complete AV septal defect and a large common AV valve • in this , ________________ • It is associated with _________

All 4 valves communicate Down’s syndrome

EISENMENGER’S SYNDROME •_______________ heart disease • These are cases of _____,____,____,_____ • With _________ and reversal of flow

Late cyanotic VSD, ASD, PDA and AVSD pulmonary hypertension

EISENMENGER’S SYNDROME • Usually the original lesions are (reparable or irreparable?) at this stage • Therefore, the repair should be done before ___________________

irreparable pulmonary hypertension builds up

CYANOTIC CONGENITAL HEART DISEASES List 5

• TETRALOGY OF FALLOT • TRANSPOSITION OF GREAT VESSELS • TRUNCUS ARTERIOSUS • TRICUSPID ATRESIA usually with ASD • TOTAL ANOMALOUS PULMONARY VENOUS CONNECTION

most common CYANOTIC CONGENITAL HEART DISEASE is ?

TETRALOGY OF FALLOT

TETRALOGY OF FALLOT • It has 4 components • 1- _________ • 2- ________ • 3- ____________ • 4- ______________

membranous VSD overiding aorta subpulmonary stenosis right ventricular hypertrophy

TETRALOGY OF FALLOT • Embryology results from ______________ of the _____________

anterior-superior displacement infundibular septum

TETRALOGY OF FALLOT: Morphology •_____ shaped heart •___ size of _______ •________ stenosis, _______ stenosis or atresia of valves and arteries

Boot VSD ; aortic orifice Subpulmonary pulmonary valve

TETRALOGY OF FALLOT: Morphology •_______ is required for survival if there is __________ of _______ valves • Other features include ______ or ________ insufficiency •_____________ in 20% of cases

PDA atresia of pulmonary valves ASD or aortic valve Right aortic arch

TETRALOGYOFFALLOT: Clinical Features • Depends on the severity of ________

pulmonary obstruction

TETRALOGYOFFALLOT: Clinical Features Those with _____ and mild pulmonary obstruction have left to right shunts and are refered to as ________

large VSD Pink Tetralogy

TETRALOGYOFFALLOT: Clinical Features Others will present with _______, __________ , ______ and in the very severe forms the baby is usually found in the _______ position

cyanosis polycythemia finger clubbing squatting

TETRALOGY OF FALLOT good Prognosis • If there is ______ - The ______ are _______

no atresia lungs are protected

TRANSPOSITION OF GREAT VESSELS • The _______ arises from the Left ventricle and the _____ from the Right ventricle

pulmonary trunk aorta

IN TRANSPOSITION OF GREAT VESSELS _____________ blood is circulated throughout the body

deoxygenated

TRANSPOSITION OF GREAT VESSELS • If _____ is present, the degree of cyanosis is ___eased • If _____ is absent, the baby may _______

PDA; decr PDA; die soon after birth

TRANSPOSITION OF GREAT VESSELS • There are 2 types of this condition • 1) _______ • 2)__________

Complete Incomplete

TRANSPOSITION OF GREAT VESSELS: Complete TGA •results from the abnormal formation of __________ • The aorta arises from the _____, lies (anterior or posterior?) and to the (left or right?) of the pulmonary trunk

truncal aortic septae Right ventricle ; anterior Right

TRANSPOSITION OF GREAT VESSELS • Complete TGA It occurs commonly in offsprings of _______ mothers

diabetic

Complete TGA is incompartible with life T/F

Transposition of Great vessels TGA with associated ______ has stable shunt while those with ——- have unstable shunt

VSD PDA

TRUNCUS ARTERIOSUS • This occurs when there is a failure of _____ and ______ of the _______ of the ____ and _____ that would ordinarily divide into the aorta and pulmonary Trunk respectively

fusion and descent spiral ridges truncus and cornua

TRUNCUS ARTERIOSUS • When the _____ fails to completely divide, the aorta and pulmonary trunk are left undivided at their outflow

spiral septum

TRUNCUS ARTERIOSUS The truncus overrides only the left ventricle T/F

F The truncus overrides both ventricles

TRUNCUS ARTERIOSUS The persistent truncus are always accompanied by _______________

membranous VSD

TRUNCUS ARTERIOSUS • The truncal valve resembles the _____ and ______ valves and may have __,___, or ___ cusps

tricuspid and aortic 2, 4 or 5

TRUNCUS ARTERIOSUS • May be associated with other defects such as: •___________ •_________ pulmonary arteries • Absence of the _________ •_________ hypoplasia

Right aortic arch Hypoplastic ductus arteriosus Pulmonary

TRICUSPIDATRESIA This occurs when there is __________________ with a (smaller or larger?) than normal _____ valve

an unusual division of the atrio-ventricular canal Larger ; mitral

TRICUSPIDATRESIA • Circulation is maintained through a _____ or a ______ • May be associated with hypoplasia of the ________

VSD; PDA right ventricle

TRICUSPIDATRESIA •_______ is usually present to channel blood from the right atrium to the left atrium • This is necessary for the _____ to function

ASD VSD

TRICUSPIDATRESIA May be associated with ______________ syndrome

hypoplastic right heart

TOTAL ANOMALOUS PULMONARY VENOUS CONNECTIONS • The ________ do not return to the ____ • They connect to the ________, _______ or some other anomalous sites • The blood is thus returned to the _______

pulmonary veins; left atrium innominate veins coronary sinus right atrium

In TOTAL ANOMALOUS PULMONARY VENOUS CONNECTIONS • There is overload of the _____ side of the heart •_______ provide free flow of oxygenated bld to the left side of the heart

right An ASD

OBSTRUCTIVE CONGENITAL LESIONS ______________ ________________ _______________

• COARCTATION OF THE AORTA • PULMONARY STENOSIS • AORTIC STENOSIS

Narrowing of the aorta is a rare structural abnormality T/F

F Common

COARCTATION OF THE AORTA • _________ of the aorta is a common structural abnormality • M:F–___:____

Narrowing 3-4:1

COARCTATION OF THE AORTA Associated with ________ Syndrome or ______ aneurysm in the brain

Turner’s Berry

COARCTATION OF THE AORTA • There are 2 classical forms • 1. _________ or ______ • 2. _______ or ________

Infantileorpreductal Adult or postductal

Ductal refers to _________

ductus arteriosus

COARCTATION OF THE AORTA: Clinical Features •This depends on the ____________

severity of the coarctation

COARCTATION OF THE AORTA: Clinical Features • -PreductalCoarctation • Usually presents in _______ • Majority (will or will not?) survive the neonatal period without surgical intervention • ______ is necessary for survival

childhood Will not PDA

COARCTATION OF THE AORTA: Clinical Features PreductalCoarctation • Cyanosis of the ______ due to the delivery of ________ through the ____ • ________ vessels are spared

lower extremities unsaturated blood PDA Upper limb

COARCTATION OF THE AORTA: Clinical Features Postductal coarctation • The ductus is closed and narrowing is ____________ • Majority of the children are (symptomatic or asymptomatic?) • Xterized by _______ of the upper limb and lower BP of lower limb

beyond origin of carotid vessels assymptomatic hypertension

COARCTATION OF THE AORTA: Clinical Features Postductal coarctation •Features of arterial insufficiency (esp.in the ____) • __________ develops between the precoarctation arterial branches and post coarctation arteries (internal mammary aa, arterial bld flow from branches of subclavian aa are directed to thoracic aorta)

Lower limb collateral circulation

COARCTATION OF THE AORTA: Clinical Features Postductal coarctation • X-rays show _____ of the ______ of the ribs, due to ______ that involve the _______

notching; undersurface collaterals intercostal arteries

COARCTATION OF THE AORTA: Clinical Features • _______ • _________ due to LVH • Untreated, death comes by the age of ___ years due to ______

Murmurs Cardiomegaly 40; CCF

COARCTATION OF THE AORTA: Clinical Features • Intracranial _______ • Infective ________ • Vascular ______ • Aortic _______ (due to degenerative changes)

haemorrhage endocarditis rupture dissection

PULMONARY STENOSIS May be isolated or associated with • -_______ • -________ • -____________ valve

TOF Transposition Dysplastic tricuspid

PULMONARY STENOSIS • When the valve is completely atretic, there is a __________ and ______

hyperplastic right ventricle and an ASD

PULMONARY STENOSIS • In pulmonary atresia, blood passes through _____ to ______ and into the lungs

an ASD to PDA

PULMONARY STENOSIS • The pulmonary trunk is hypoplastic if there is a __________ as in _____

subpulmonary stenosis TOF

PULMONARY STENOSIS is Associated with RVH T/F

AORTIC STENOSIS AND ATRESIA • This is usually associated with ______ of the _________ tract with ______________ syndrome

underdevelopment left ventricular outflow hypoplastic left ventricular

AORTIC STENOSIS AND ATRESIA • Isolated in ___% of cases

AORTIC STENOSIS AND ATRESIA • there are 3 major types • 1-_____ • 2- ________ • 3- _______

valvular subvalvular supravalvular

AORTIC STENOSIS AND ATRESIA Supra valvular stenosis is narrowing __________. Usually ________. Also seen in ______ syndrome ( ________ in ________ )

above the aortic valve inherited William; hypercalcaemia in children

AORTIC STENOSIS AND ATRESIA ________ is the most common form .

Valvular

AORTIC STENOSIS AND ATRESIA Subvalvular stenosis includes obstruction by a _________ or by _____________

fibrous band asymmetric muscular hypertrophy.

A unicuspid aortic valve is fatal T/F