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Cardio Exam 2 > Congenital Heart Disease - Review Day of Test > Flashcards

Congenital Heart Disease - Review Day of Test Flashcards

1
Q

what is the most common birth defect?

A
  • congenital heart disease
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2
Q

disorder with 22q11

A
  • truncus arteriosus

- tetralogy of Fallot

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3
Q

disorder with down syndrome

A
  • ASD
  • VSD
  • AV septal defect
  • endocardial cushion defect
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4
Q

disorder with congenital rubella

A
  • septal defects
  • PDA
  • pulmonary artery stenosis
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5
Q

defect with Turner syndrome

A
  • coarctation of aorta
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6
Q

defect with Marfan’s syndrome

A
  • aortic insufficiency and dissection
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7
Q

defect with infant of diabetic mother

A
  • transposition of great vessels
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8
Q

normal pressure gradient in the heart

A
  • L pressure > right pressure
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9
Q

transition from fetal circulation

A
  • closing of patent foramen ovale

- closing of patent ductus arteriosus

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10
Q

long standing left to right shunts

A
  • increase pulmonary arterial pressure and volume
  • pulmonary arteriolar hypertrophy
  • reversal to right to left shunt
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11
Q

eisenmenger’s syndrome

A
  • reversal to right to left shunt
  • deoxygenated blood flows to body
  • causes early cyanosis
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12
Q

acyanotic presentation

A
  • intracardiac or vascular stenosis
  • valvular regurgitations
  • left to right shunts
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13
Q

cyanotic presentation

A
  • poorly oxygenated blood shunted from right heart to left

- blood bypass fetal lungs

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14
Q

O2 sat of cyanotic presentation

A
  • 80-85%
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15
Q

acyanotic conditions

A
  • atrial septal defect
  • ventricular septal defect
  • patient ductus arteriosus
  • congenital aortic stenosis
  • pulmonic stenosis
  • coarctation of aorta
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16
Q

cyanotic conditions

A
  • truncus arteriosus
  • transposition of the great vessels
  • tricuspid atresia
  • tetralogy of fallot
  • total anomalous pulmonary venous return
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17
Q

atrial septal defects caused by

A
  • defect in septum between right and left atria
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18
Q

what happens in atrial septal defects

A
  • blood from LA moves to RA
  • RV volume load and enlargement
  • delayed closing of pulmonic valve
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19
Q

result of delayed closing of pulmonic valve

A
  • fixed split S2 murmor at upper left and right sternal borders
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20
Q

atrial septal defects due to

A
  • ostium secundum (most common)
  • osmium primum
  • sinus venosus
  • patient foramen ovale
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21
Q

ostium secundum defect

A
  • due to inadequate formation of septum secundum or excessive resorption of septum primum
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22
Q

ostium primum defect

A
  • inferior portion of septum fails to fuse with endocardial cushion
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23
Q

sinus venosus defect

A
  • unroofing of area between pulmonary veins and RA
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24
Q

patent foramen ovale

A
  • persistence of foramen ovale
  • atrial septa fail to fuse
  • source of paradoxical emboli
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25
Q

how would a paradoxical emboli form

A
  • DVT move from RA to LA

- go into body/brain and block arteries

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26
Q

symptoms of ASD

A
  • most usually asymptomatic
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27
Q

adults with ASD

A
  • may have atrial tachyarrhythmia due to right atrial enlargement
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28
Q

percent of membranous ventricular septal defects

A
  • 70%
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29
Q

percent of muscular ventricular septal defects

A
  • 20%
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30
Q

VSD due to

A
  • defect in septum that separates right and left ventricles
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31
Q

initial blood flow in VSD

  • result
A
  • left to right shunt
  • pulmonary hypertension
  • RV hypertrophy
32
Q

later blood flow in VSD

A
  • pressure RV > LV
  • right to left shunt
  • Eisenmeyer’s syndrome
33
Q

murmor in VSD

A
  • harsh holosytolic murmur heart at lower left sternal border
34
Q

pulmonary venous congestion due to

A
  • left heart failure
35
Q

pulmonary venous congestion symptoms

A
  • tachypnea
  • respiratory distress
  • difficulty feeding
  • cyanosis
  • sweating
36
Q

systemic venous congestion due to

A
  • right heart failure
37
Q

systemic venous congestion symptoms

A
  • hepatosplenomegaly

- edema/asites

38
Q

PDA cause

A
  • failure of ductus arteriosus to close
39
Q

blood flow in PDA

A
  • left to right shunt between aorta and pulmonary artery ]

- decreased diastolic systemic perfusion

40
Q

later result of PDA

A
  • pulmonary hypertension reverses shunt

- leads to Eisenmeyer’s syndrome

41
Q

murmor in PDA

A
  • machine like murmur heard best at lower sternal border
42
Q

PDA on CXR

A
  • increased heart size
43
Q

1st line treatment for PDA

A
  • indomethacin
44
Q

MOA of indomethacin

A
  • prostaglandin synthesis inhibitor
45
Q

symptoms of Eisenmeyer’s

A
  • cyanosis
  • clubbing
  • polycythemia
46
Q

aortic stenosis most common in which gender?

47
Q

aortic stenosis cause

A
  • narrowing of the aorta
48
Q

result of aortic stenosis

A
  • requires lots of LV pressure to pump blood
  • left ventricular hypertrophy
  • high velocity jet may cause dilation of proximal aorta
49
Q

cause of pulmonic stenosis

A
  • right ventricular outflow obstruction

- abnormal formation/regression of subendocardial mesenchymal tissue

50
Q

result of pulmonic stenosis

A
  • impaired RV outflow
  • increases RV pressure and RV hypertrophy
  • may cause RV heart failure
51
Q

coarctation of aorta due to

A
  • narrowing of aortic lumen
52
Q

theories of coarctation of aorta

A
  • no flow no grow

- ectopic ductal tissue

53
Q

no flow no grow theory

A
  • if blood doesn’t flow to an area, that area won’t develop as well
54
Q

ectopic ductal tissue theory

A
  • ectopic muscular tissue from ductus arteriosus constricts following birth
55
Q

blood flow in coarctation

A
  • less blood flows to lower limbs because of narrowing of valve
  • more blood flows to upper limbs through greater branches of the aorta
56
Q

result of coarctation of aorta

A
  • BP of upper extremity is high

- BP of lower extremity will be low

57
Q

cause of persistent truncus arteriosus

A
  • failure of truncus arteriosus to divide into pulmonary trunk and aorta
58
Q

most patient with truncus arteriosus have

A
  • accompanying VSD
59
Q

symptoms of truncus arteriosus

A
  • early cyanosis

- patients have partially deoxygenated blood flowing through systemic circuit

60
Q

cause of transposition of great arteries

A
  • aorta leaves RV

- pulmonary trunk leaves LV

61
Q

what is the most common cause of neonatal cyanosis

A
  • transposition of the great arteries
62
Q

cause of TGA

A
  • failure of aorticopulmonary septum to spiral in normal fashion
63
Q

result of TGA

A
  • 2 parallel circuits

- most infants die without a shunt placed

64
Q

cause of tricuspid atresia

A
  • absent tricuspid valve
65
Q

result of tricuspid atresia

A
  • hypoplastic RV
66
Q

what does tricuspid atresia require for viability

A
  • ASD and VSD
67
Q

most common form of early cyanotic congenital heart disease

A
  • tetralogy of fallot
68
Q

things found in tetralogy of Fallot (TOF)

A
  • pulmonic stenosis
  • right ventricular hypertrophy
  • overriding aorta
  • VSD

PROV

69
Q

pulmonic stenosis in TOF causes

A
  • right to left shunt leading to cyanosis
70
Q

murmor heard in TOF

A
  • left upper sternal border
71
Q

CXR of TOF

A
  • boot shaped heart
72
Q

Tet spell with TOF

A
  • dyspnea with exertion
73
Q

how do kids reverse TOF Tet spell?

A
  • squat to increase pressure on aorta

- blood moves back to pulmonary artery then lungs

74
Q

cause of total anomalous pulmonary venous return (TAPVR)

A
  • pulmonary veins drain into right heart circulation instead of left heart
  • going the opposite of what you would expect it to.
75
Q

TAPVR associated with

A
  • ASD +/- PDA to allow for right to left shunt to maintain cardiac output
76
Q

cure for TOF

A
  • early surgical repair

Cardio Exam 2 (29 decks)

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