Congenital heart disease Flashcards
In fetal circulation, SVR is ___ and PVR is ____
SVR is low, PVR is high
The ductus venous bypasses the ____ and shunts blood from the umbilical vein to the IVC
Bypasses the liver
The ductus arteriosus shunts blood from the ___ to the ___ bypassing the ____
pulmonary artery to the aorta bypassing the lungs
There is ___ umbilical vein that carries oxygenated blood from the mother to the fetus
one
There are ____ umbilical arteries that carry deoxygenated blood from the fetus to the mother
2
Fetal circulation is arranged in ____ and adult circulation is ____
Fetal circulation is arranged in PARALLEL and adult circulation is SERIES
With the first breath, PAO2 ____ and co2 ___, PVR ____
PAO2 increases, Co2 decreases, PVR decreases
What increases PVR?
Hypercarbia, hypoxemia, acidosis, atelectasis, Trendelenburg, hypothermia, vasoconstrictors, light anesthesia, pain.
What are the cyanotic shunts? (right to left)
TOF, transposition of the great arteries, Ebstein’s anomaly, trunctus arteriosis, total anomolous pulmonary venous connection
Which shunts are ACYANOTIC? (left to right)
VSD, ASD, PDA, coarctation of the aorta
A right to left shunt is associated with a ____ inhalation induction and a _____ IV induction.
Slower inhalation, faster IV
A left to right shunt is associated with a ____ inhalation induction and a _____ IV induction.
FasterISH/minimal inhalation, slower IV
Esienmenger syndrome is when a left to right shunt switches to a right to left shunt because of _________
pulmonary hypertension
What is TOF?
The most common cyanotic congenital heart anomaly
What 4 defects come with TOF?
- RV outflow tract obstruction
- RV hypertrophy from RV tract obstruction
- VSD
- Overriding aorta that receives blood from both ventricles
How does a TET spell present?
Hypoxemia and cyanosis
Best way to treat TOF?
Ketamine is best. Avoid morphine, meperidine, atracurium
(histamine release), keep adequate preload and SVR
Which direction is flow through an ASD usually in?
Left to right
Where is the best place to monitor arterial BP on a patient getting surgery for coarctation of the aorta?
right arm
What are 2 signs of coarctation of the aorta?
Systolic higher in upper extremities
Differential cyanosis will be present
What drug do you give before coarctation of the aorta surgery?
Prostaglandin E1 - it keeps the ductus arteriosis open which helps peruse the lower extremities
The patient scheduled for a fontan procedure most likely has….
Hypoplastic left heart syndrome
It’s a single ventricle
