Congenital heart disease

Question 1

management strategies cyanotic heart disease

Answer 1

• infective endocarditis prevention- prophlactic abx + good oral hygiene
• aim relative anamia (pts have sec erythrocytosis)- phlebotomy if haematocrit>65 hb> 200
• avoid anticougulants /antiplatelet
• suppress menorghia- (can cause fe deif- worsen erytthrocytosis)

Question 2

Risk factors for Eisenmengers syndrome (from congenital disease)

Answer 2

size of left to right shunt

Ventricular shunts- higher risk than atrial

Question 3

Triad eisengmenger syndrome

Answer 3

systemic to pulmunary congenital shunting
Pulmunary arterial disease
cyanosis

Question 4

Management Eisengmenger syndrome

Answer 4

AVOID pregnancy

• avoid volume depletion
• avoid mod/sev exercise
• Avoid excess heat (vasodilation- decrese systemic resis- increase R to L shunt
• High Altitude
• advanced theraphy- endothelin antagonist/phoshpo diesterase inhib
• avoid fe deif
• transplant? if not pul vasc resitance