Congenital Heart Disease Flashcards

1
Q

What changes to foetal circulation happen at birth?

A

Increase in SVR
Decrease in pulmonary vascular resistance
This causes increase in RA pressure
Foramen ovale pushed closed
Ductus arteriosus also closes and becomes the ligament arteriosus

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2
Q

How is congenital heart disease usually detected?

A

Antenatal sanning

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3
Q

What are tested to detect congenital heart disease in newborns?

A

Femoral pulses
Heart sounds
Presence of murmurs
Pre and post ductal saturations

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4
Q

What factors of murmurs make them likely to be innocent?

A
Soft
Systolic
Short
S1 and 2 normal
Symptomless
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5
Q

What causes cyanosis in newborns?

A

If a lesion allows blood to bypass the lungs or mixed oxygenated and deoxygenated blood to enter circulation

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6
Q

What can cyanosis in newborns be a symptom of?

A

Respiratory disease

Persistent pulmonary hypertension of the newborn

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7
Q

When does the ductus arteriosus close?

A

Day 4-7

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8
Q

What does collapse at day 4-7 indicate?

A

Duct dependent lesion

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9
Q

What are symptoms of heart failure?

A
Failure to thrive
Slow/reduce feeding
Breathlessness
Sweatiness
Hepatomegaly
Crepitations
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10
Q

When do symptoms of heart failure usually occur in newborns?

A

4-6 weeks

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11
Q

In which situation would a heart defect not cause cyanosis?

A

If lesion only shunts blood left to right, or no shunting

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12
Q

What are some heart defects that do not cause cyanosis?

A
Atrial septal defect
Ventricular septal defect
Atrioventricular septal defect
Atrial stenosis
Pulmonary stenosis
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13
Q

What are some heart defects that cause cyanosis?

A
Truncus arteriosus
Tetralogy of Fallot
Transposition of the great vessels
Tricuspid atresia
Total anomalous pulmonary venous connection
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14
Q

In a duct dependent lesion where the patient relies on a patient ductus arteriosus to maintain oxygenation, what management is done?

A

Prostaglandin e2infusion to keep it open until surgery

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15
Q

What is a buzzword for patent ductus arteriosus?

A

Machinery murmur

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16
Q

What is the management for patent ductus arteriosus?

A

NSAIDs or surgical repair

17
Q

What is coarctation of the aorta?

A

Narrowing of the aorta

18
Q

Where does coarctation of the aorta usually affect?

A

Proximal thoracic aorta

19
Q

What are the clinical signs of coarctation of the aorta?

A

Radio-femoral delay
Strong upper body pulses
Weak lower limb pulses
Rib notching

20
Q

What does coarctation of the aorta cause?

A

Hypertension and LV hypertrophy above the lesion and hypoperfusion below

21
Q

What is in the differential for hypertension in a young person?

A

Coarctation of the aorta

22
Q

What are all patients with congenital heart disease at an increased risk of?

A

Infective endocarditis

23
Q

What is Eisenmenger’s syndrome?

A

Long standing left to right shunt causes pulmonary hypertension
The increased pressure over time causes reversal of this shunt to right to left, causing cyanosis