Congenital Heart Disease

Question 1

what are signs of a congenital heart disease during pregnancy and after brith?

Answer 1

antenatally: USS abnormalities
birth: cyanosis
day 1-2: murmurs, cyanosis, abnormal pulse
day 3-7: sudden circulatory collapse, shock, cyanosis, SCD
4-6 weeks: reduced feeding, failure to thrive, breathless, sweaty

Question 2

what are long term factors to consider

Answer 2

developmental problems, emotional and psychological problems

Question 3

what is transposition of great vessels

Answer 3

aorta comes from RV rather than LV

Question 4

what happens in duct dependent lesions

Answer 4

circulation halts due to duct collapse- this is an emergency

Question 5

signs of duct collapse

Answer 5

sever cyanosis/ pallor, tachypnoea, distress, rapid deterioration

Question 6

tx for duct collapse

Answer 6

ABCDE, prostaglandin E2, supportive

Question 7

what are clinical signs of heart failure in newborn?

Answer 7

failure to thrive, slow feeding, breathlessness, sweaty, hepatomegaly, creps

Question 8

what is VSD?

Answer 8

hole in ventricular septum

Question 9

what type of murmur can be heard in newborns with VSD

Answer 9

pan systolic murmur

Question 10

ix for VSD

Answer 10

echo

Question 11

tx for VSD

Answer 11

potentially surgery

Question 12

what is patent ductus arteriosis

Answer 12

the ductus arteriosis which is physiological before birth fails to close meaning there is an opening between 2 major vessels leaving heart

Question 13

cause of patent ductus arteriosis

Answer 13

lung vascular resistance fails to drop so shunts remain

Question 14

what is a main sign of patent ductus arteriosus

Answer 14

large difference in pre and post ductal O2 stats

Question 15

tx for patent ductus arteriosus

Answer 15

ventilation, O2, inhaled NO, ECLS (ECMO / VAD-basically bypass mechanisms)

Question 16

who is more likely to have persistent pulmonary HT

Answer 16

sick babies e.g. sepsis or anatomical abnormality at birth

Question 17

what are 2 subtypes of duct dependent lesions

Answer 17

duct dependent systemic circulation and duct dependent pulmonary circulation

Question 18

what are 4 types of duct dependent systemic circulation diseases

Answer 18

hypoplastic left heart (RA & LA have no border)
critical aortic stenosis
interrupted aortic arch
critical contraction of aorta

Question 19

what are 2 types of duct dependent pulmonary circulation diseases?

Answer 19

tricuspid atresia

pulmonary atresia

Question 20

what doe atresia mean?

Answer 20

abnormal narrowing/absence of body opening/passage e.g. pulmonary atresia is absence of pulmonary valve and replaced with solid tissue