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Histopathology > Congenital Heart Disease > Flashcards

Congenital Heart Disease Flashcards

1
Q

What is the prevalence of congenital heart diseases (CHDs) in the US?

A

Nearly 1% or about 40,000 births per year.

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2
Q

What is the most common type of congenital heart defect?

A

Ventricular Septal Defect (VSD).

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3
Q

What percentage of babies with non-critical CHDs survive to 18 years of age?

A

About 95%.

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4
Q

What are the survival rates for babies with critical CHDs?

A

About 69% survive to 18 years of age.

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5
Q

List common features of an atrial septal defect.

A

Right ventricular heave, widely split S2, grade I-III/VI systolic murmur at the upper left sternal border.

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6
Q

When is treatment indicated for atrial septal defects?

A

Elective closure for large defects at 4-5 years of age.

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7
Q

Describe the murmur in a ventricular septal defect (VSD).

A

Grade II-IV/VI harsh pansystolic murmur heard best at the lower left sternal border.

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8
Q

What characterizes a patent ductus arteriosus (PDA)?

A

Bounding pulses, widened pulse pressure, and a continuous machinery murmur.

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9
Q

When is treatment recommended for small PDAs?

A

If a murmur is present due to the risk of endarteritis.

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10
Q

What are ‘tet spells’?

A

Sudden, potentially lethal episodes of severe cyanosis, often in Tetralogy of Fallot.

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11
Q

What antenatal factors may suggest CHDs?

A

Cardiac malformations, fetal arrhythmias, hydrops on antenatal scans.

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12
Q

What maternal illnesses are associated with CHDs?

A

Diabetes, rubella, and use of teratogenic medications.

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13
Q

List key features on physical examination indicating CHDs.

A

Dysmorphism, central cyanosis, tachypnea, heart murmurs, hepatomegaly.

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14
Q

What does the hyperoxia test involve?

A

Administering 100% oxygen, measuring ABG, with pO2 < 100 mmHg indicating cyanotic heart disease.

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15
Q

What are the initial stabilization steps for managing CHDs?

A

Secure airway, ensure ventilation, provide circulatory support, and correct metabolic derangements.

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16
Q

When is IV prostaglandin E infusion used?

A

For duct-dependent lesions to maintain ductus arteriosus patency.

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17
Q

What are adverse effects of IV prostaglandin E?

A

Apnea, fever, hypotension.

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18
Q

What conditions might present similarly to unresponsive duct-dependent lesions?

A

Transposition of great arteries, obstructed total anomalous pulmonary venous return.

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19
Q

What is the characteristic murmur in PDA?

A

Continuous machinery murmur best heard at the upper left sternal border.

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20
Q

What are common symptoms of critical CHDs in infants?

A

Cyanosis, dyspnea with feeding, poor growth, and hypercyanotic spells.

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21
Q

What is the role of echocardiography in CHDs?

A

To confirm structural abnormalities and assess heart function.

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22
Q

What percentage of under-five deaths in Malaysia in 2006 were related to CHDs?

A

0.1

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23
Q

How are small atrial septal defects managed?

A

No treatment if asymptomatic.

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24
Q

What is a common chest X-ray finding in CHDs?

A

Cardiac enlargement (cardiomegaly).

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25
Q

What are the most common chromosomal syndromes associated with CHDs?

A

Trisomy 21, 18, 13, and Turner syndrome.

26
Q

Why is family history important in diagnosing CHDs?

A

CHDs often have a genetic component.

27
Q

How does the pulse pressure change in PDA?

A

It becomes widened.

28
Q

What are cyanotic heart diseases indicated by a hyperoxia test?

A

Conditions with a pO2 < 100 mmHg and minimal rise in pO2 after oxygen administration.

29
Q

What are the main goals of initial CHD management?

A

Stabilize the patient and prepare for transfer to a cardiac center if needed.

30
Q

What is the treatment for moderate to large PDAs?

A

Anti-failure therapy, surgical or transcatheter closure based on symptoms and size.

31
Q

What are bounding pulses indicative of in CHD?

A

Patent ductus arteriosus (PDA).

32
Q

What diagnostic measure confirms cyanotic heart disease in neonates?

A

Hyperoxia test with ABG analysis.

33
Q

What imaging is critical for assessing congenital heart defects?

A

Echocardiography.

34
Q

Which CHD is most commonly asymptomatic?

A

Atrial septal defect (ASD).

35
Q

What is the prognosis for most children with non-critical CHDs?

A

Survival to adulthood is expected in 95% of cases.

36
Q

What is the significance of a single second heart sound in CHD?

A

It is common in cyanotic conditions like Tetralogy of Fallot.

37
Q

How are heart murmurs in CHDs graded?

A

Based on intensity, from grade I (softest) to grade VI (loudest).

38
Q

What defines critical congenital heart disease?

A

Defects requiring intervention in the first year of life to prevent mortality.

39
Q

What physical exam findings suggest heart failure in CHDs?

A

Hepatomegaly, tachypnea, and weak or unequal pulses.

40
Q

Why is prompt cardiology consultation crucial in CHDs?

A

To ensure early diagnosis and intervention.

41
Q

What is the hallmark symptom of cyanotic heart disease in newborns?

A

Central cyanosis.

42
Q

What does a harsh systolic murmur at the left upper sternal border suggest?

A

Tetralogy of Fallot or other cyanotic heart defects.

43
Q

What conditions may be associated with dysmorphism in CHDs?

A

Genetic syndromes like Down syndrome or Turner syndrome.

44
Q

What general management is essential for duct-dependent lesions?

A

IV prostaglandin E infusion to maintain ductal patency.

45
Q

What investigation detects fetal cardiac malformations antenatally?

A

Ultrasound scans.

46
Q

Why might a cyanotic infant need immediate intervention?

A

To prevent hypoxia-related organ damage or mortality.

47
Q

What is the main treatment goal for large atrial septal defects?

A

Surgical closure to prevent complications like heart failure or arrhythmias.

48
Q

What symptom is commonly seen with feeding in cyanotic CHDs?

A

Dyspnea or difficulty feeding due to inadequate oxygenation.

49
Q

Which CHD is characterized by a machinery murmur?

A

Patent ductus arteriosus (PDA).

50
Q

What are ‘tet spells’ and how are they managed?

A

Episodes of cyanosis in Tetralogy of Fallot; managed with squatting, oxygen, or medications.

51
Q

What are common perinatal problems linked to CHDs?

A

Prematurity, meconium aspiration, and perinatal asphyxia.

52
Q

Why is metabolic acidosis corrected in CHDs?

A

To stabilize the patient and prevent further complications.

53
Q

What are general measures for stabilizing infants with CHDs?

A

Adequate ventilation, circulatory support, and preventing hypothermia.

54
Q

How is a ventricular septal defect murmur described?

A

A harsh, medium-to-high-pitched pansystolic murmur.

55
Q

What does hepatomegaly in a neonate suggest in CHDs?

A

Right heart failure or systemic venous congestion.

56
Q

What is the first-line medication for duct-dependent CHDs?

A

IV prostaglandin E infusion.

57
Q

What does a single second heart sound indicate?

A

Cyanotic heart disease like Tetralogy of Fallot.

58
Q

Additional question 58

A

Additional answer.

59
Q

Additional question 59

A

Additional answer.

60
Q

Additional question 60

A

Additional answer.

Histopathology (10 decks)

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