Congenital Heart Disease Flashcards
what causes the closure of the oval foramen after a neonate is born?
increased left atrial pressure pressing on the valve
what causes the closure of the ductus arteriosus in neonates?
bradykinin and decreased prostaglandins act on the wall
what is the most common congenital heart defect?
bicuspid aortic valve (marfan’s)
lesions that allow circulation of deoxygenated blood in the systemic circulation via shunting
cyanotic CHD
oxygenated blood from the left to the right heart
acyanotic CHD
what can obstructive lesions lead to? (2)
ventricular hypertrophy
heart failure
what is an example of a cyanotic CHD?
tetralogy of fallot
what is an example of a left and right sided obstruction?
coarctation of the aorta
in large atrial septal defects, infants will present with what?
right-sided heart failure
what are 2 common symptoms in adults age 40 in uncorrected defects?
atrial arrhythmias
exercise intolerance
on physical, you hear a widely split S2. After heart failure develops, you hear a 4th heart sound. what could this be?
atrial septal defect
what is the diagnostic test of choice for atrial septal defect?
echocardiogram
what would an ECG show to indicate atrial septal defect?
crochetage pattern
what size atrial septal defect at diagnoses is unlikely to spontaneously close?
over 8-10 mm
what is the first line treatment for atrial septal defect? (2)
anticoags
cardioversion
what treatment for atrial septal defect can be considered for adults with severe pulmonary vascular disease?
vasodilator
what is the second line treatment for a repaired atrial septal defect?
antibiotics
what type of atrial septal defects should be closed in children?
secundum >8mm in children older than 2 years
what is the standard treatment for a sinus venosus, coronary sinus, or primum atrial septal defect?
surgical repair
what is the treatment of choice of secundum atrial septal defect in adults?
percutaneous closure
closure of an atrial septal defect is not indicated in patients who have developed irreversible _____ _____
pulmonary hypertension
congenital or acquired defect of the interventricular septum that allows communication of blood between the left and right ventricles
ventricular septum defect
ventricular septal defect can occur as a complication of what?
acute MI
prolonged left to right shunting of blood in ventricular septal defect can lead to _____ _____
pulmonary hypertension
a triad of left to right shunting, pulmonary arterial disease, and cyanosis
eisenmenger syndrome
an infant that typically appears asymptomatic, now presents with respiratory distress, tachypnea, tachycardia, diaphoresis with feeds, and poor weight gain. what are they likely experiencing?
ventricular septal defect
what is the diagnostic test to use for ventricular septal defect?
cardiac catheterization
what is the treatment for ventricular septal defects? (2)
diuretics
ACE inhibitor
what can an infant develop due to ventricular septal defect?
anemia
when should antibiotics be used for ventricular septal defect? (2)
complex cyanotic heart disease
during first 6 mo after surgery
what medications can be used for ventricular septal defect in an adult? (2)
digoxin
diuretics
what is the treatment for ventricular septal defect if the infant has pulmonary HTN, failure to thrive, and flow is poorly controlled?
VSD patch or repair
what is a common complication after surgery for a ventricular septal defect?
RBBB
persistence of the fetal communication between the descending aorta and main pulmonary artery
patent ductus arteriosus
what is the diagnostic of choice for patent ductus arteriosus?
echocardiogram with doppler
what medication is indicated to treat patent ductus arteriosus?
NSAIDS
how do NSAIDS close a patent ductus arteriosus?
inhibit local prostaglandin synthesis
when is antibiotic prophylaxis recommended for patent ductus arteriosus?
previous endocarditis
when is PDA closure considered? (2)
volume overload
signs of pulmonary HTN
what condition leads to left ventricular pressure overload, myocardial hypertrophy, and heart failure if left untreated?
coarctation of the aorta
a patient presents with lower limb claudication, syncope, chest pain, irritability, poor feeding in infant, and diaphoresis. what are they likely experiencing?
coarctation of the arota
a patient presents with brachial-femoral delay, prominent neck pulsations, and bruit and palpable pulsation in the intercostal spaces. what are they likely experiencing?
coarctation of the aorta
along with brachial-femoral delay, this patient also presents with underdevelopment of lower extremities in CoA. what age group are they?
older children/adults
along with brachial-femoral delay, this patient presents with tachypnea, prominent right ventricular impulse, hepatomegaly, and cyanotic skin. what age group are they?
infant
what is the diagnostic of choice for CoA?
echo
what is the treatment for CoA until repair is complete?
alprostadil (prostaglandin E1)
why should we treat CoA with alprostadil?
to maintain patency of ductus arteriosus in infancy
what are the four features of tetralogy of fallot?
ventricular septal defect
pulmonary valve stenosis
aorta that overrides (rightward)
RV hypertrophy
what is the most common cyanotic malformation to reach adulthood without reparative surgery?
tetralogy of fallot
a patient presents with low birth weight, dyspnea on exertion, squatting after exercise, cyanosis of nail beds and lips, digital clubbing and palpable RV impulse. what are they likely experiencing?
tetralogy of fallot
a symptom of paroxysmal episodes of worsening cyanosis and rapid, deep breathing, noticed after feeding and defecation
tet spell
what is used to diagnose tetralogy of fallot?
echo
what would a chest radiography show when looking at tetralogy of fallot?
boot-shaped heart
what is the treatment for tetralogy of fallot? (3)
oxygen
prostaglandins
knee-chest position during hypoxemic spells
what is the acute treatment for tetralogy of fallot? (4)
phenylephrine
oxygen
morphine
propranolol
what are 2 surgical treatments for tetralogy of fallot?
complete surgical repair
palliative surgery
