Congenital Heart Disease Flashcards
What are the three major groups of Congenital Heart Disease?
- left-to-right shunts, right-to-left shunts, and obstruction
What occurs in a Right-to-Left Shunt?
- the pulmonary circulation is decreased/bypasses, so deoxygenated blood enters the systemic circulation
Four main Right-to-Left Shunt defects
- tetralogy of Fallot, transposition of the great vessels, truncus arteriosus, and tricuspid atresia
What occurs in a Left-to-Right Shunt?
- systemic blood inappropriately enters the pulmonary circulation, increasing the pressure in the pulmonary circulation and eventually causing RV hypertrophy and failure
Three main Left-to-Right Shunt defects
- atrial septal defect (ASD), ventricular septal defect (VSD), and patent ductus arteriosus (PDA)
Which type of shunt is more common? What is the most common congenital heart defect?
- left to right shunts are more common
- VSDs are the most common
Atresia
- complete obstruction of a chamber, valve, or vessel from a congenital malformation
T or F: patients with Right-to-Left shunts will usually present with immediate cyanosis.
- true!
- these patients have deoxy blood entering their systemic circulation
- (in contrast, left-to-right shunts don’t immediately cause cyanosis, as blood still enters the pulmonary circulation)
Eisenmenger’s Syndrome
- cyanosis that eventually occurs in left-to-right shunts
- the RV hypertrophy resulting from increased pulmonary volume and pressure eventually causes the pressure in the right side of the heart to exceed that of the left side
- the shunt is now a right-to-left shunt and cyanosis will occur
In an infant with aortic or pulmonary atresia, why is PGE given?
- PGE = prostaglandin-E; it keeps the ductus arteriosus open
- we want it to stay open because it is the only thing that is maintaining systemic/pulmonary circulation due to the atresia
- (PGE is given to keep it open until surgery can be done)
Tetralogy of Fallot
- P.R.O.Ve.
- Pulmonary stenosis, RV hypertrophy, Overriding aorta, Ventricular septal defect
- these four defects result in a right-to-left shunt, where blood flows from the RV straight into the aorta
Transposition of the Great Vessels
- a right-to-left shunt
- the RV pumps blood into the aorta
- the LV pumps blood into the pulmonary trunk
- creates two separate circulations that do not interact
Infantile Aortic Coarctation
- an obstructive congenital heart defect
- hypoplasia of the aortic arch results in a narrowing of the vessel, restricting blood flow through the area
- LV hypertrophy will result from the increased resistance to blood flow; dilation will occur proximal to the coarctation
- HTN in upper extremities, hypotension in lower
Which septal defect can result in paradoxical emboli?
- ASD
- allows venous emboli to end up in the systemic system
Which defect is associated with Fetal Alcohol Syndrome?
- VSD
Which defect is associated with Down Syndrome?
- ASD
Which defect is associated with Congenital Rubella?
- PDA
____ keeps the Ductus Arteriosus open, while ______ closes it.
- PGE keeps it open
- indomethacin closes it
T or F: Eisenmenger’s Syndrome in PDA will result in cyanosis.
- true!
- however, it will only result in cyanosis of the lower extremities, as the PDA occurs after the main branches of the aorta supplying the upper extremities
What type of murmur is associated with PDA?
- a machine-like murmur
Why do patients with Tetralogy of Fallot squat?
- squatting increases systemic resistance, increasing the afterload, and increasing the pressure on the aorta/left side of the heart, allowing more blood to enter the now more easily accessible pulmonary trunk (so that the blood can get oxygenated)
Which defect is associated with Maternal Diabetes?
- transposition of the great vessels
Truncus Arteriosus
- a right-to-left shunt
- a single large vessel arising from both ventricles due to the truncus failing to divide
Which defect is associated with Turner’s Syndrome?
- coarctation of the aorta
