Congenital Heart Disease Flashcards
What is the definition of congenital heart disease?
Abnormalities of the heart’s structure that are present at birth
Congenital heart disease affects ____ out of every ____ newborns.
1 out of every 125
Each year, more than ____-____ babies in the United States are born with congenital heart defects.
35,000 - 40,000
What are the three types of CHD?
Shunt lesions, obstructive lesions, and cyanotic lesions.
What are some examples of shunt lesions?
ASD, VSD, PDA, PFO
What are some examples of obstructive lesions?
Pulmonary stenosis, pulmonary atresia, tricuspid atresia, or Ebstein’s anomaly.
What are some examples of cyanotic lesions?
Double outlet right ventricle (DORV), Total anomalous pulmonary vein return (TAPVR), Transposition of the great arteries (TGA), Truncus arteriosus, Single ventricle, Eisenmenger syndrome, Hypoplastic left heart syndrome (HLHS), Tetralogy of Fallot (TOF).
The endocardium and the cardiac jelly participate in the formation of the ____.
Endocardial cushions
The outer myocardial mantle eventually becomes the ____.
Muscular wall of the heart
What are the five areas of the heart tube?
Sinus venosus, common atrium, common ventricle, bulbus cordis, truncus anteriosus.
What does the sinus venosus eventually form?
The proximal vena cava (SVC and IVC)
What does the common atrium eventually form?
RA and LA
What does the common ventricle eventually form?
RV and LV
What does the bulbus cordis eventually form?
The RVOT and LVOT
What does the truncus anteriosus eventually form?
The roots of the aorta and pulmonary arteries
At what week does the heart begin to loop?
Week 4
At ____-____ weeks the heart is fully developed and any CHD that is going to be present has occurred.
6 - 8
The left side of the sinus venosus eventually…
Is obliterated
The right side of the sinus venosus eventually…
Becomes incorporated into the RA as it grows (this fold is the eustachian valve).
As the cardiac tube begins to loop, the truncus anteriosis and bulbus cordis begin to movie ___.
Down and to the right
As the cardiac tube begins to loop, the primitive ventricle begins to move ___.
Left of the midline
As the cardiac tube begins to loop, the primitive atria begin to move ____.
Posterior (back) and superior
When does the atrial septal formation begin?
At the end of week 4
A small opening near the atrioventricular valves permits continued communication between the two ventricles until later when it is closed by the ____ and ____ portions of the IVS.
Membranous and perimembranous
What do the endocardial cushions form?
The septal TV leaflet, the anterior MV leaflet, and a portion of the inflow perimembranous IVS.
What do the lateral cushions form?
The anterior and posterior TV leaflets and the posterior MV leaflet.
What happens to the third set of aortic branches?
The common and internal carotid artery
In what week do the aortic arches form?
Week 4
What happens to the left fourth set of aortic branches?
The aorta
What happens to the sixth set of aortic branches?
The right and left pulmonary arteries
What happens to the first and second set of aortic branches?
They just disappear
A right-sided liver and left-sided stomach is usually associated with atrial situs ____
Solitus
Morphologic RA always contains the ____ valve.
Eustachian
The appendage of the ____ ____ is shorter and broader than that of the LA.
Morphologic RA
Morphologic LA has no eustachian valve and has a more ____ shape than the right atrium.
Rounded
Normally the aorta lies to the ____.
Left
The IVC lies to the ____ of the spine.
Right
____ ____ connect to the LA normally; however, you cannot use the connection as a deciding factor for atrial situs or morphology.
Pulmonary veins
True or false: You can have atrial situs but have abnormal pulmonary vein connections.
True
Atrial situs is best determined in the ____ view.
Subcostal
What are the three steps to the segmental approach?
1: Determine atrial situs and assess venous inflow patterns to the atria (SVC, IVC, Pulm veins)
2: Determine atrioventricular connections and determine ventricular morphology and position.
3: Evaluate ventriculoarterial relationships.
D-looping allows the RV to develop ____ and to the ____ of the LV.
Anteriorly; right
With L-looping the morphologic RV is to the ____ of the morphologic LV
Left
What anatomy markers are part of the RV?
- has muscle bundles
- moderator band
- heavily trabeculated
What anatomy markers are part of the LV?
- has a smooth endocardial surface
- two papillary muscles
The ____ valves ALWAYS follow the corresponding ventricle.
AV valves
The leaflets of the TV insert more ____ than MV.
Apically
The TV usually has ____ papillary muscles.
Three
The MV has a more ____ septal attachment.
Basal
The MV usually has ____ papillary muscles.
Two
The ____ has chordal insertions into the septum, while the ____ does not.
TV; MV
The final step in the segmental approach to cardiac anatomy involves identification of the ____ ____ and their respective connections.
Great arteries
Normally with concordant connections, the morphologic LV gives rise to the ____.
Aorta
Normally with concordant connections, the ____ serves as the outlet of the RV.
Pulmonary artery
In normal hearts the pulmonary artery sits ____ and ____.
Anterior and leftward
In normal hearts the aorta sits ____ and ____.
Posterior and rightward
In normal hearts the aortic arch goes to the ____.
Left
____-transposition, ventricular relationship is normal, with the morphologic RV located to the right of the morphologic LV.
D-transposition
____-transposition, atrioventricular discordance is present (because of formation of an L-loop during development), the morphologic RV lies to the left of the morphologic LV.
L-transposition
