Congenital Heart Disease (3) Flashcards
What is a left to right shunt?
- Blood from left heart is returned to lungs instead of body
- Increased lung blood flow
- By itself it isn’t damaging
What can be the causes of congenital heart disease?
- Genetics: Downs/Turners
- Environmental: teratogenicity from drugs/alcohol
- Maternal infections: Rubella, toxoplasmosis
What are the four main types of acyanoitc congenital heart disease?
- Acyanotic:
- Left to right shunts: ASD, VSD, PDA
- Obstructive lesions: aortic stenosis: hypoplasia
- Pulmonary stenosis: valve, outflow, branch
- Coarctation of aorta, mitral stenosis
What are the four types of cyanotic congenital heart disease?(complex right to left shunts)
- Tetralogy of fallot (VSD/pulmonary stenosis)
- Transposition of great arteries
- Total anomalous pulmonary venous damage
- Univentricular heart
What are the four types of shunts?
- Atrial
- Ventricular
- Atrio-ventricular
- Ventricular-pulmonary
What is ASD?
- Atrial septal defects:
- Increased pulmonary blood flow
- RV volume overload
- Pulmonary hypertension is rare
- Eventual right heart failure
What is VSD?
- Ventricular septal defects:
- Left to right shunt
- LV volume overload
- Pulmonary venous congestion
- Eventual pulmonary hypertension
What is tetralogy of fallot?
- Pulmonary stenosis
- Ventricular septal defect
- Right ventricular hypertrophy
- Over-riding aorta
What is tricuspid atresia?
- No right ventricle inlet
- Right to left atrial shunt of entire venous return
- Blood flow to lungs via VSD
What is hypoplastic left heart?
- Left ventricle is underdeveloped
- Ascending aorta is very small
- Right ventricle supports systemic circulation
- Obligatory right to left shunt
What is transposition of the great arteries?
- Right ventricle is connected to aorta
- Left ventricle is connected to pulmonary artery
- Not viable unless 2 circuits communicate via atrial/ventricular/ducktail shunts
What is a univentricular heart?
- One ventricle
- Less control of blood flow to lungs/systemic
- Same pressure to both
- Possible deoxygenated blood to body
What is a pulmonary atresia?
- No right ventricle outlet
- Right to left atrial shunt of entire venous return
- Blood flow to lungs via PDA
What is the typical history of ASD?
- Asymptomatic late in adulthood
- Late onset arrhythmia
- Right heart failure
What is the typical history of VSD?
- Unless is very small, presents in infancy with left heart failure
- Untreated can lead to in-operable pulmonary hypertension
What is the typical history of coarctation?
- Neonatal variety: associated with PDA, right to left shunt
- Adult variety: complicated by renal hypertension, left ventricle hypertrophy often associated with aortic valve stenosis
What is the typical history of tetralogy of fallot?
- Present in infancy/early childhood with cyanotic spells
- Mild cases are compatible with adulthood
What are the typical histories for the following:
- Transposition of great arteries
- Hypoplastic left heart
- Pre-ductile coarctation
- Pulmonary atresia
- Presenting as neonatal emergencies
- Due to restricted blood flow
