Congenital Heart Disease 2 (Mayo) Flashcards
Pink hands and blue feet. Dx?
Eisenmenger’s with PDA
Cyanosis/clubbing, a-wave JVP, RV heave, click, diastolic murmur of PR from PA dilation, loud P2. Dx?
Eisenmenger’s
Eisenmenger’s CXR
Big “mogul #2” from big PA, calcified PA
Drug class to avoid in eisenmenger’s
Vasodilators (no NTG)
Rx for eisenmenger’s
PAH Rx: Bosentan, sildenafil, prostacyclin
Tet of fallot
- large sub aortic VSD
- RVOT obstruction (+/-PS)
- overriding Ao
- RVH
DDR of overriding Ao
TOF, Pulm atresia, truncus
Which lesion in TOF determines security of TOF?
RVOT obstruction (b/c blue blood sneaks over from RV to LV and causes cyanosis)
Difference between RV and LV pressures in TOF
RVp = LVp
Name 3 associated lesions with TOF
- R- Ao arch on CXR
- anomalous coronary artery
- Secundum ASD
TOF PE
Cyanosis RV lift Thrill if PS severe Systolic murmur over pulmonic area ABSENT P2
Most common problem after TOF repair
PR–> RV inc–> inc QRS–> VT–> SCD
EKG findings in TOF
RBBB
Wide QRS
What is the repair for TOF?
RVOT patch
Close VSD
Excise PV
What is next step if pt with TOF repair comes in with arrhythmia ?
Look for Hemodynamic abnormality (most likely PR which should be promptly corrected with PVR)
What is the purpose of creating a shunt for congenital heart diseases?
Increase blood flow through pulmonary vasculature
Glenn
SVC–> RPA
Bidirectional Glenn
SVC to RPA and LPA
Blalock-Tausigg
Subclavian Artery–> PA
Waterston shunt
Asc Ao–>RPA