Congenital Heart Disease Flashcards

1
Q

What are the four sources of shunting in fetal circulation?

A

1) placenta

2) ductus venosus (liver)

3) foramen ovale

4) ductus arteriosus

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2
Q

What does the foramen ovale do?

A

shunts blood from right to left

allows you to take blood directly to brain

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3
Q

What can cause a small head?

A

transposition of great arteries

oxygenated blood isn’t going to the head since it is getting shunted to the pulmonary veins

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4
Q

What allows blood to bypass lungs?

A

ductus arteriosus

connects aorta to pulmonary artery

allows oxygenated blood to bypass the lungs

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5
Q

What happens to foramen ovale at birth?

A

higher LAP shuts it closed

pressure snaps the door shut

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6
Q

What is the foramen ovale?

A

hole between the left / right side of the heart

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7
Q

What two values drop at birth?

A

pulmonary resistance and pulmonary pressure

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8
Q

What 2 things close the ductus arteriosis?

A

1) PaO2 increases

2) prostaglandin drops

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9
Q

What forms the aorticopulmonary septum?

A

neural crest cells

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10
Q

What can lead to transposition of great vessels, ToF, etc?

A

aorticopulmonary septum problems

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11
Q

What is most common form of ASD?

A

secundum ASD from increased reabsorption of septum

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12
Q

What becomes dilated in ASD?

A

the atria from increased volume

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13
Q

What side of heart will become hypertrophied in ASD?

A

right-side due to the left to right shunt

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14
Q

What is a key PE finding of coarctation of aorta?

A

difference in LE and UE blood pressure

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15
Q

What is commonly associated with coarctation of aorta?

A

bicuspid aortic valve

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16
Q

If you hear a murmur in the back, what does this point to?

17
Q

Is coarctation of aorta a pressure or volume lesion?

A

a pressure lesion due to increased afterload needed

can lead to LVH

18
Q

What causes coarctation of aorta?

A

problem with ductal arteriosus closure which causes a kink

19
Q

When does ductal arteriosus normally close?

A

5-7 days after birth

20
Q

What happens to aortic flow in coarctation of aorta?

A

continuous flow in diastole since you can’t get blood through

21
Q

What would you do if you have critical CHF with coarctation of aorta?

A

try to keep the DA open through prostaglandin use

22
Q

What are the 5Ts of cyanosis?

A

Truncus arteriosus

Transposition

Tricuspid atresia

Tetralogy of fallot

Total anomalous pulmonary venous return (TAPVR)

23
Q

What type of shunts cause cyanosis?

A

right to left shunts

oxygen poor blood isn’t flowing back to lungs, is flowing the rest of the body

24
Q

Concave MPA segment indicates …

A

tetralogy of Fallot

25
Where is aorta in tetralogy of Fallot?
sitting overtop of ventricular septum
26
What makes murmur worse in ToF?
more pulmonary stenosis
27
Why does agitation worsen ToF?
increased HR means less filling time and less preload even less oxygenated blood to go through systemic circulation
28
What does cyanosis mean?
deoxygenated blood is going to aorta (blue blood) rather than the lungs
29
What does knee to chest do in ToF?
increased preload
30
What else can you do to break exacerbation of ToF?
decrease HR give phenyleprine (increase preload without increasing HR)
31
Why can you not give supplemental O2 in ToF?
blood isn't ever going to lungs to get oxygenated oxygen will not travel into systemic circulation
32
How does TGA present?
small head normal besides cyanosis at birth
33
What happens in TGA?
right ventricle pumps into the aorta which circulates deoxygenated blood into system left ventricle pumps into pulmonary vein and oxygenated blood just circles around lungs
34
How can you fix TGA?
tear a hole in the atrial septum to allow more mixing of oxygenated and deoxygenated blood made ASD / PFO can also use prostaglandins to help for a little