Congenital Heart Disease Flashcards
What are the acyanotic congenital heart diseases ?
(ASD), (VSD), Atrioventricular Septal Defect (AV Canal), (PDA), aortic coarctation, pulmonary stenosis
What is ASD?
opening in the atrial septum permitting free communication of blood between the atria. Seen in 10% of all CHD
What are symptoms of ASD?
Most are asymptomatic but may have easy fatigability or mild growth failure. Cyanosis does not occur unless pulmonary HTN is present.
What will you find on clinical exam with an ASD?
Hyperactive precordium, RV heave, fixed widely split S2. systolic ejection murmur @ LSB. Mid-diastolic murmur heard over LLSB
What causes the murmurs associated with ASD?
Systolic murmur is caused by increased flow across the pulmonary valve, NOT THE ASD. Diastolic murmur is caused by increased flow across the tricupsid valve
What is the treatment for ASD?
Surgical or catherization laboratory closure is generally recommended for secundum ASD. Closure is performed electively between ages 2 & 5 yrs.
Is endocarditis prophylaxis required for ASD?
No because it’s a low velocity shunt. No lesions or venturi effect
What is VSD?
is an abnormal opening in the ventricular septum, which allows free communication between the Rt & Lt ventricles. Accounts for 25% of CHD.
Why does the left to right shunt occur in VSD?
The left to right shunt occurs secondary to PVR being < SVR, not the higher pressure in the LV. This leads to elevated RV & pulmonary pressures & volume hypertrophy of the LA & LV
What are clinical signs of VSD?
harsh holosystolic murmur heard along the LSB, more prominent with small VSD. Prominent S2, Diastolic murmur. hyperactive precordium. Symptoms develop between 1 – 6 months
What are treatment options for VSD?
Surgery: Ages 6-12 mo w/ large VSD & Pulm. HTN. Age > 24 mo w/ Qp:Qs ratio > 2:1. Supracristal VSD of any size, secondary to risk of developing AV insufficiency
What is an AVSD?
incomplete fusion of the endocardial cushions, which help to form the lower portion of the atrial septum, the membranous portion of the ventricular septum and the septal leaflets of the triscupid and mitral valves.
What genetic disease is commonly associated with AVSD?
Down’s Syndrome (Trisomy 21), Seen in 20-25% of cases
What are symptoms of AVSD?
Congestive heart failure in infancy. Recurrent pulmonary infections. Failure to thrive. Exercise intolerance, easy fatigability. Late cyanosis from pulmonary vascular disease w/ R to L shunt
What clinical signs will you notice on physical exam with AVSD?
Hyperactive precordium. Normal or accentuated 1st hrt sound. Wide, fixed splitting of S2. Pulmonary systolic ejection murmur w/thrill. Holosystolic murmur @ apex w/radiation to axilla. Mid-diastolic rumbling murmur @ LSB. Marked cardiac enlargement on CX-Ray
What is treatment for AVSD?
Surgery is always required. Treat congestive symptoms. Pulmonary banding maybe required in premature infants or infants < 5 kg
What is a PDA?
Persistence of the normal fetal vessel that joins the PA to the Aorta. Accounts for 10% of all CHD
What TORCH infection is PDA associated with?
rubella