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cardiovascular > congenital heart disease - atrial septal defect, ventricular septal defecft > Flashcards

congenital heart disease - atrial septal defect, ventricular septal defecft Flashcards

1
Q

how often do they occur

A

in about 1% of all live births

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2
Q

who is more likely to get it women or men

A

men

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3
Q

which diseases are more common in females

A
  • atrial septal defect

- persistent ductus arteriosus

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4
Q

how is oxygen and nutrients supplied to the foetus

A

via the placenta and umbilical vein

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5
Q

where does the blood go

A

half to the fetal ductus venous and carried to the IVC

other half enters the liver

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6
Q

where does the blood move after the IVC

A

the right atrium

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7
Q

what is significant about foetal heart

A

there is an opening between right and left atrium

so blood flows from the right to left

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8
Q

what happens to blood in left ventricle

A

pumped through the aorta through the internal iliac arteries and re-enters the placenta

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9
Q

where does carbon dioxide go

A

taken up and enters the mothers circulation

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10
Q

where does the blood form the right atrium go that doesn’t go into the left atrium

A

enters the right ventricle and is pumped into the pulmonary artery

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11
Q

what is the ductus arterioles

A

connection between the pulmonary artery and the aorta

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12
Q

how does the foramen ovale close

A

due to increase in left atrial pressure

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13
Q

when does the ductus arteriosus usually close off

A

1-2 days after birth

this completely separates left and right systems

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14
Q

when does the umbilical vein and ductus venous close off

A

within 2-5 days of birth

leaving behind the ligaementum teres and the ligamentum venosus of the liver

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15
Q

what are some causes

A
  • maternal prenatal rubella infection
  • maternal alcohol misuse
  • maternal drug treatment and radiation
  • genetic abnormalities
  • chromosomal abnormalities
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16
Q

what does alcohol misuse cause

A

septal defects

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17
Q

what is Turner syndrome associated with

A

coarctation of aorta

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18
Q

what is Down syndrome associated with

A
  • septal defects

- mitral and tricuspid valve defects

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19
Q

common symptoms

A
  • central cyanosis
  • pulmonary hypertension
  • finger clubbing
  • paradoxical embolism
  • polycythaemia
  • growth retardation
  • syncope
  • squatting
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20
Q

why does cyanosis occur

A

because of right to left shunting of blood

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21
Q

what disease occurs with cyanosis

A

Fallots tetraology

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22
Q

why does hypertension occur

A

large left to right shunt

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23
Q

what tis pulmonary hypertension known as

A

Eisenmengers reaction

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24
Q

what is finger clubbing associated with

A

prolonged cyanosis

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25
what can polycythaemia develop secondary to
chronic hyperaemia
26
what does polycythaemia increase risk of
stroke
27
when is syncope common
when severe right of left ventricular outflow tract is obstructed
28
when does syncope occur
in Fallots tetralogy associated with cyanosis
29
when does squatting occur
Fallots tetraology
30
what is most common congenital cardiac abnormalities
ventricular septal defect
31
when left ventricular pressure is higher than right where does blood move
from the left to the right
32
if large defect what does it lead to
- pulmonary hypertension | - Eisenmengers complex
33
what happens when blood starts to move from right to left
cyanosis
34
what is in small restrictive VSD
pan systolic murmur
35
does small VSD produce abnormal CXR or ECG
no
36
what is seen on CXR of larger defects
prominent pulmonary arteries causing increased blood flow
37
when there is cardiomegaly what is seen on ECG
left and right ventricular hypertrophy
38
what does echo do
assess the size and location of the VSD
39
treatment for VSD
- surgical patch repair | - device closure
40
what are the indications for treatment in VSD
left atrial and ventricular enlargement
41
when is atrial septal defect usually diagnosed
adulthood
42
who's more likely to get atrial septal defect men or women
women
43
what are the 3 types of atrial septal defect
- sinus venous defects - ostium secundum defect t - ostium primum defects
44
where is sinus venous located
in superior part of the septum near superior vena cava or IVC
45
where is ostium secundum
located in mid septum
46
where is ostium premium located
in lower part of atrial septum
47
what can be felt in atrial septal defect
right ventricular heave
48
what is done for investigating atrial septal defect
- CXR - ECG - echo
49
what is seen on CXR for ASD
prominent pulmonary arteries with pulmonary plerotha
50
what is seen on ECG for ASD
right bundle branch block and right axis deviation
51
what is seen on echo for ASD
hypertrophy and dilatation or right heart and pulmonary arteries
52
what allows calculation of the left to right shunt for ASD
Doppler
53
what are indications for treatment in ASD
- ASD with signifiant left to right shunting - thromboembolic events - patent foramen ovale
54
what are the treatment options in ASD
- device closure using transcatheter clamshell device | - surgical closure
55
what keeps patent ductus arteriosus open
prostaglandin E
56
what does prostaglandin E2 require for synthesis
COX
57
what is patent ductus arteriosus
persistent communication between the proximal left pulmonary artery and descending aorta resulting in left to right shunt
58
when does ductus arteriosus usually close
couple hours after birth
59
what is given to stimulate duct closure
indomectacin a prostaglandin inhibitor
60
what happens if shunt is large in patent ductus arteriosus
results in left heart volume overload some cases pulmonary hypertension
61
signs of patent ductus arteriosus
- bounding pulse - machinery murmur - thrill can be felt
62
what is used for investigation of patent ductus arteriosus
- CXR - ECG - echo
63
what is seen on CXR of patent ductus arteriosus
aorta and pulmonary arterial system are prominent
64
what is seen on ECG of patent ductus arteriosus
left atrial abnormality and left ventricular hypertrophy
65
what is seen on echo of patent ductus arteriosus
dilated left atrium and left ventricle
66
what are indications for treatment of patent ductus arteriosus
left ventricular dilatation and mild to moderate pulmonary arterial hypertension
67
what is coarctation of aorta
narrowing of aorta just distal to the insertion of the ductus arteriosus
68
who gets coarctation of aorta more commonly men or women
men
69
what is coarctation of aorta associated with
Turners syndrome
70
what is the aortic valve like in coarctation of aorta
bicuspid
71
what does severe narrowing of aorta encourage the formation of
collateral arterial circulation
72
signs and symptoms of coarctation of aorta
- systolic murmur heard over upper precordium of the back - vascular bruits - headaches - nosebleeds - claudication - cold legs - hypertension in upper limbs - weak delayed pulses in legs
73
investigation for coarctation of aorta
CXR ECG echo
74
what is seen on CXR for coarctation of aorta
- dilated aorta indented at the site of coarctation | - aorta looks like a '3'
75
what is seen on ECG for coarctation of aorta
left ventricular hypertrophy
76
what is treatment of coarctation of aorta in neonates
surgical repair
77
what is treatment of coarctation of aorta in older children and young adults
balloon dilatation and stenting surgery is preferred
78
what is Fallot's tetraology characterised by
an aorta overriding the ventricular septum and arising from the right ventricle
79
symptoms and signs of Fallot's tetraology
- systolic ejection murmur - cyanosis - squatting
80
what can occur with Fallot's tetraology
DiGeorge syndrome

cardiovascular (36 decks)

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