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Gen Path > Congenital Heart Disease > Flashcards

Congenital Heart Disease Flashcards

1
Q

Structural abnormalities present at birth

A

congenital heart disease

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2
Q

4 reasons for congenital heart disease

A

Chromosomal abnormalities
Environmental associations
Rubella
Genetic predisposition

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3
Q

Turner syndrome (XO) is associated with

A

coarctation of the aorta

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4
Q

Down syndrome (trisomy 21) is associated with

A

Atrial and ventricular septal defects
Atrioventricular valve deformities

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5
Q

There is an increase in __ in pregnancy at high altitudes

A

Patent ductus arteriosus

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6
Q

Rubella (german measles) is a prominent cause of CHD. Congenital rubella syndrome causes

A

cardiovascular malformations
Microcephaly

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7
Q

Common cardiac malformations associated with congenital rubella syndrome

A

Pulmonary artery stenosis
Patent ductus arteriosus

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8
Q

This is a genetic predisposition

A

Tetralogy of fallot

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9
Q

CHD can be classified according to the presence or absence of

A

cyanosis

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10
Q

Non-cyanotic CHD

A

left to right shunt ( patent ductus arteriosis or atrial or ventricular septal defect)

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11
Q

This can cause obstructive lesion like coarctation of the aorta and aortic stenosis

A

Non-cyanotic CHD

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12
Q

Transposition of the great vessels, malformations with a right to left shunt (tetralogy of fallot), left to right shunt reverses flow to right to left because of increased pulmonary pressure

A

Cyanotic CHD

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13
Q

A hole from a septum secundum or septum primum defect

A

Atrial septal defect (ASD)

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14
Q

Atrial septal defect produces a __

A

left to right non-cyanotic shunt

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15
Q

2nd most common CHD

A

Atrial septal defect

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16
Q

Smooth walled defects near the foramen ovale, NO other cardiac abnormalities

A

Ostium secundum ASD’s (75% of ASDs)

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17
Q

At lowest part of atrial septum, associated with mitral and tricuspid valve abnormalities

A

Ostium primum ASDs (15-20% of ASDs)

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18
Q

Upper part of atrial septum near superior vena cava, accompanied by anomalous drainage of the pulmonary veins into right atrium or superior vena cava

A

Sinus venosis (5-10% of ASDs)

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19
Q

Small ASDs can __ while large ASDs can __

A

close at birth ( or be asymptomatic throughout lifetime)
cause heart failure

20
Q

Unresolved large ASDs are delayed until __ and can lead to __

A

4th decade of life
Right heart failure

21
Q

Increased incidence of atrial arrhythmias (atrial fibrillation), can lead or paradoxical embolism

A

Atrial septal defect ASD

22
Q

A flaplike opening between atria septa primum and secumdum at the location of the fossa ovalis that persists after age 1

A

Patent foramen ovale (PFO)

23
Q

Little clinical significance except when it leads to paradoxical embolism or cryptogenic strokes <55 years of age

A

Patent foramen ovale (PFO)

24
Q

Normally the __ keeps the PFO closed but transient __ can occur such as with valsalva-type manuvers

A

left atrial pressure
R to L blood flow

25
Q

A hole within the intraventricular septum that produces a left to right non-cyanotic shunt

A

Ventricular septal defect (VSD)

26
Q

This is the most common CHD!

A

Ventricular septal defect (VSD)

27
Q

Larger ventricular septal defects can cause __

A

tachypnea, tachycardia and heart failure

28
Q

In adults with untreated VSD __ is common

A

Left sided heart failure

29
Q

With __ the shunt will reverse flow to right to left in VSD

A

pulmonary hypertension

30
Q

Failure of closure of the fetal ductus arteriosis

A

Patent ductus arteriosus (PDA)

31
Q

Patent ductus arteriosus produces a __

A

Left to Right non-cyanotic shunt

32
Q

3rd most common CHD

A

Patent ductus arteriosis (PDA)

33
Q

Can be due to premature/low birth weight, low oxygen tension, 1st trimester maternal rubella

A

patent ductus arteriosis (PDA)

34
Q

Narrowing or constriction of the aorta - occurs near the ligamentum arteriosim just distal to the origin of the left subclavian artery

A

Coarctation of the aorta

35
Q

Coarctation of the aorta can lead to

A

left ventricular outflow obstruction

36
Q

The narrowing that occurs with coarctation of the aorta can be __ or __ in relation to ductus arteriosus

A

preductal (infantile)
Postductal (adult)

37
Q

This is usually present in preductal coarctation the the aorta

A

patent ductus arteriosus

38
Q

Symptomatic early in life, classically as cyanosis localized to the lower half of the body (without treatment infants die in neonatal)

A

Preductal coarctation of the aorta (with PDA)

39
Q

Usually asymptomatic, sometimes well into adult life, when symptoms develop, hypertension is limited to the upper extremities and cerebral vessels with low blood pressure in the lower extremities

A

Postductal coarctation of the aorta (WITHOUT PDA)

40
Q

The most common form of cyanotic (right to left) CHD

A

Tetralogy of fallot (TOF)

41
Q

4 major features of tetralogy of fallot

A

Obstruction of the right ventricular outflow tract
Concentric right ventricular hypertrophy
Ventricular septal defect (VSD)
Dextroposition of the aorta

42
Q

Obstruction of the right ventricular outflow tract can be due to what 3 things

A

subpulmoic stenosis
pulmonary calce stenosis
complete atresia

43
Q

What is the definitive treatment for TOF

A

Complete surgical repair

44
Q

Decreased pulmonary blood flow and increased aortic volumes are present at birth with

A

Tetralogy of fallot (TOF)

45
Q

The second most common form of cyanotic (right to left) CHD

A

Transposition of the great arteries (TGA)

46
Q

In transposition of the great arteries, the aorta arises from the __ and the pulmonary artery emanates from the __

A

right ventricle
Left ventricle

47
Q

What is needed for survival of a patient with transposition of the great arteries

A

a concurrent compensatory anomaly (VSD) (ASD) (PDA)

Gen Path (11 decks)

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