Congenital Heart Disease

Question 1

what two categories are congenital heart diseases divided into?

Answer 1

cyanotic and acyanotic

cyanotic means baby turns blue because low oxygen from defect flow

Question 2

name the six acyanotic lesions

Answer 2

atrial septal defect
ventricular septal defect
patent ductus arteriosus
congenital aortic stenosis
pulmonic stenosis
coarctation of the aorta

Question 3

what is the most common atrial septal defect?

Answer 3

ostium secundum

Question 4

what is another atrial septal defect?

Answer 4

patent foramen ovale

Question 5

what is a risk with an older person with old patent foramen ovale?

Answer 5

stroke

Question 6

what two chambers of the heart enlarge with atrial septal defect?

Answer 6

right atrium and right ventricle because of shunt from left to right and abnormally larger volumes in right system

Question 7

with a ventricular septal defect…what chambers of the heart enlarge and why?

Answer 7

all except the right atrium…due to increased volume in right ventricle resulting in increased pressure to the left atrium and left ventricle

Question 8

name the three signs of heart failure in an infant

Answer 8

tachypnea
respiratory distress
difficulty feeding

will often see cyanosis and sweating

Question 9

with a patent ductus arteriosus…what chambers of the heart get enlarged and why?

Answer 9

the left atrium and ventricle because they become overloaded with blood as it passes from aorta and to pulmonary artery

Question 10

what happens to diastolic systemic perfusion with patent ductus arteriosus

Answer 10

decrease because of aorta flowing into pulmonary artery

Question 11

what is the only congenital heart defect that has a drug treatment?

Answer 11

patent ductus arteriosus

Question 12

what is the drug used to treat patent ductus arteriosus?

Answer 12

indomethacin

Question 13

what is the MOA of indomethacin?

Answer 13

it is a prostaglandin synthesis inhibitor and prostaglandins keep the ductus open so if you decrease them the ductus arteiosus will close

Question 14

define Eisenmenger syndrome…when does it occur?

Answer 14

this is when pulmonary tension has been high for so long that it finally reaches a pressure that is greater than the left and the shunt goes back to the left

this is when you have ASD, VSD or PDA

Question 15

what are the symptoms of eisenmenger syndrome?

Answer 15

cyanosis and clubbing

Question 16

which chamber of the heart is enlarged with aortic stenosis

Answer 16

left ventricle

Question 17

which chamber of the heart is enlarged with pulmonic valve stenosis?

Answer 17

right ventricle

Question 18

define coarctation of the aorta

Answer 18

this is a narrowed aortic lumen

Question 19

what can the aorta rely on for blood flow if severe coarctation?

Answer 19

a patent ductus arteriosus

Question 20

which chamber might enlarge in coarcation of the aorta?

Answer 20

left ventricle

Question 21

what is the persistent truncus arteriosus?

Answer 21

failure of the truncus arteriosus to divide into the pulmonary trunk and the aorta…usually have a VSD too

Question 22

what happens with transposition of the great vessels?

Answer 22

aorta linked to RV and pulmonary trunk to LV

get cyclic flow in separate sides of heart so easily leads to cyanotic babies

Question 23

with transposition of the great vessels..what circulation is the baby dependent on?

Answer 23

fetal circulation

Question 24

what happens in tricuspid atresia?

Answer 24

no tricuspid valve…leads to hypoplastic RV

Question 25

what do you need for survival with tricuspid atresia

Answer 25

ASD and VSD

Question 26

name the four issues with tetralogy of fallot

Answer 26

VSD pulmonic stenosis overriding aorta RVH

Question 27

explain why tetralogy of fallot leads to cyanosis

Answer 27

with VSD, pulmonic stenosis and overriding aorta... you get lots of flow out of the aorta and pretty much none to the lungs pretty much a right to left shunt

Question 28

what is a tet spell?

Answer 28

dyspnea on exertion leads to cyanosis from worsening R to L shunt in tetralogy of fallot so when baby cries they get bluer

Question 29

what is a total anomalous pulmonary venous return

Answer 29

pulmonary veins drain into the wrong locations...specifically the right heart circulation...pretty much creates a cyclical issue in right system

Question 30

name the 5 cyanotic heart defects

Answer 30

``` truncus arteriosus transposition of great vessels tricuspid atresia tetralogy of fallot total anomalous pulmonary venous return ```