Congenital Heart Disease Flashcards
What are the different types of congenital heart defects
Atrial septal defects
Ventricular septal defects
Patent ductus arteriosus
Great vessel malformations
Describe finger clubbing
Swelling of the terminal digits of the hands
Changes in the nail bed angle to the finger, flattening the normal dip between the finger tissue and the nail bed
Which diseases can lead to finger clubbing
Cardiac diseases
Lung diseases
Inflammatory bowel diseases
Liver cirrhosis
What is cyanosis
An increase in deoxygenated haemoglobin in the blood
Exists when there is 5g/dl or more of deoxygenated Hb in the blood
What are the different types of cyanosis and what are their causes
Central - congenital heart disease
Peripheral - cold environment
What causes central cyanosis
Poor oxygenation of the blood
Either poor flow of blood through the lungs to the tissues or oxygenated and deoxygenated blood mixing after the lungs leading to a CO with a reduced oxygenated level
How does central cyanosis present
Warm body tissues but still blue
Tongue and lips easiest to see
Peripheral tissues also look blue
How does peripheral cyanosis present
Affects particular tissues
Cold extremities
Vascular spasm such as Raynaud’s disease
Describe Raynaud’s disease
Spasm of the blood vessels to the peripheral tissues in cold circumstances, restricting blood flow to the end of the fingertips causing them to have slow circulation and more deoxygenated blood
What investigations can be carried out in patients for congenital heart defects and why
Doppler ultrasound scan
Possible to see blood flow through the valves and detects any defects in the cardiac wall
Defects will show that there is blood where there shouldn’t be and which direction the blood is flowing
Where do atrial septal defects occur
Between the left and right atria
What percentage of all septal defects are atrial septal defects
20-40%
Describe an atrial septal defect
Pressure within the left atria is higher than in the right so the blood flow will be from the left side to the right meaning that oxygenated blood is being passed to be mixed with deoxygenated blood in the right side then being passed to the lungs to be oxygenated again
Do patients with atrial septal defects show cyanosis
Blood that reaches aorta will be oxygenated so the patient will not show cyanosis
Why do atrial septal defects increase the workload of the heart
Part of the CO is recirculating through the lungs and can lead to heart failure because of the increased strain on the heart
What does an atrial septal defect look like on an x-ray
Bulge in the right side of the heart due to atrial hypertrophy
Describe a ventricular septal defect
Blood is forced into the right side as well as up the aorta
As pressure is greater, the amount of blood forced back into the right ventricle will be treated and the volume of blood recirculating through the lungs will be higher
What is the endocarditis risk of patients with septal defects
Low in patients with atrial septal defects
Higher in patients with ventricular septal defects as there is more turbulent blood flow
What is the risk of heart failure in septal defects
Higher in ventricular septal defects but still existing in atrial septal defects
How can septal defects be closed
Some shrink naturally with time and require no intervention
Open heart surgery and directly close the defect
Insertion of a mesh on each side of the defect by arterial access
What is coarctation of the aorta
Narrowing of the aorta just after the left carotid artery
What causes coarctation of the aorta
Ductus arteriosus in the foetus carrying blood from the pulmonary artery into the aorta has constricted, continuing around more of the aorta than it should do, creating a narrowing that restricts blood flow to the systemic arteries of the lower parts of the body
What is unaffected by coarctation of the aorta
Brain, head, neck and right arm are unaffected
What is affected by coarctation of the aorta
Left arm and lower limbs will have reduced blood flow
What is patent ductus arteriosus
When the ductus fails to close
What is the outcome of patent ductus arteriosus
There is greater pressure in the aorta than the ductus, blood will start to flow in the wrong direction in the ductus, back to the lungs
Is coarctation of the aorta an endocarditis risk
No
Is patent ductus arteriosus an endocarditis risk
Yes
