Congenital Heart Disease

Question 1

Compare the shape of the left and right ventricle

Answer 1

L = cylindrical R = wraps around L

Question 2

What is the O2 saturation in the arterial blood?

Answer 2

100%

Question 3

What is the O2 saturation in the venous return?

Answer 3

67%

Question 4

What is the mixed venous pressure? (pressure in RA)

Answer 4

0-4

Question 5

What is the pressure in the RV?

Answer 5

25(systole)/4(diastole)

Question 6

What is the pressure in the pulmonary artery?

Answer 6

25(systole)/10(diastole)

Question 7

What is the pressure in the LA?

Answer 7

8-10

Question 8

What is the pressure in the LV

Answer 8

120(systole)/10(diastole)

Question 9

What is the pressure in the aorta?

Answer 9

120(systole)/80(diastole)

Question 10

Explain the L to R heart shunt

Answer 10

Requires a hole, blood from L goes to lungs instead of body, increase pulmonary artery/venous pressure can be damaging

Question 11

Explain a R to L heart shunt

Answer 11

Requires a hole and distal obstruction to raise the RV pressure, de-oxygenated blood bypasses lungs

Question 12

How can congenital heart defects be classified?

Answer 12

Acyanotic (L to R) and cyanotic (R to L)

Question 13

What is a secundum atrial septal defect?

Answer 13

failure in any stage of the septum primum and septum secundum fusing together

L to R shunt, RV volume overload, Increased pulmonary blood flow, Eventual right heart failure

Question 14

Can atrial septal defects change?

Answer 14

yes - they can get larger with aging of patient due to pressure blood has exerted

Question 15

What is seen in ventricular septal defects?

Answer 15

L to R shunt, LV volume overload = raised RV pumped out as normal but larger vol returns overloading the L side of the heart

Question 16

What syndrome is an atrioventricular septal defect associated with?

Answer 16

Down syndrome

Question 17

Describe what an atrioventricular septal defect looks like

Answer 17

hole between all of the heart’s chambers and problems with the valves that regulate blood flow

Question 18

What is coarctation?

Answer 18

congenital narrowing of a short section of the aorta – ductal tissue causes the sucking in collateral circulation develops

weak femoral pulse

radial-femoral delay

radial-radial delay

Question 19

Outline tricuspid atresia?

Answer 19

No RV inlet = congenital absence of tricuspid valve. 3rd most common cyanotic congenital heart defect blood flow to lungs by VSD (ventricular septal defect)

Question 20

Describe hypoplastic left heart

Answer 20

rare

L heart is severely underdevel, ascending aorta underdevel, right ventricle supports systemic circulation by ASD, PDA

Question 21

What is pulmonary atresia?

Answer 21

No RV outlet, R to L shunt of entire venous return blood flow to lungs via PDA

Question 22

What is Tetralogy of Fallot

Answer 22

PROVe

Pulmonary stenosis Right Ventricular Hypertrophy Over-riding Aorta Ventricular Septal Defect

Question 23

What is transposition of the great arteries?

Answer 23

Right Vent connected to Aorta

Left Vent connected to Pulmonary Artery

not viable unless the 2 circuits communicate via atrial ventriclar or ductal shunts

Question 24

Give examples of L to R shunts

Answer 24

ASD: atrial septal defect VSD: ventricular septal defect PDA: patent ductus arteriosus

Question 25

Give an example of bi-directional shunting

Answer 25

Transposition of the great arteries

Question 26

Give examples of R to L shunts

Answer 26

Tricuspid atresia Tetralogy of fallot Hypoplastic left heart Pulmonary atresia

Question 27

Name the cyanotic vs acyanotic congential heart defects

Answer 27

Acyanotic =

atrial septal defect, venticualr septal defect, PDA, aortic stenosis, pulmonary stenosis, coarctation, mitral stenosis

Cyanotic =

tetraolgy of fallot, transposition of great vessels, tricuspid atresia, pulmonary atresia, hypoplastic left heart