Congenital Heart Disease - Review Day of Test Flashcards
1
Q
what is the most common birth defect?
A
- congenital heart disease
2
Q
disorder with 22q11
A
- truncus arteriosus
- tetralogy of Fallot
3
Q
disorder with down syndrome
A
- ASD
- VSD
- AV septal defect
- endocardial cushion defect
4
Q
disorder with congenital rubella
A
- septal defects
- PDA
- pulmonary artery stenosis
5
Q
defect with Turner syndrome
A
- coarctation of aorta
6
Q
defect with Marfan’s syndrome
A
- aortic insufficiency and dissection
7
Q
defect with infant of diabetic mother
A
- transposition of great vessels
8
Q
normal pressure gradient in the heart
A
- L pressure > right pressure
9
Q
transition from fetal circulation
A
- closing of patent foramen ovale
- closing of patent ductus arteriosus
10
Q
long standing left to right shunts
A
- increase pulmonary arterial pressure and volume
- pulmonary arteriolar hypertrophy
- reversal to right to left shunt
11
Q
eisenmenger’s syndrome
A
- reversal to right to left shunt
- deoxygenated blood flows to body
- causes early cyanosis
12
Q
acyanotic presentation
A
- intracardiac or vascular stenosis
- valvular regurgitations
- left to right shunts
13
Q
cyanotic presentation
A
- poorly oxygenated blood shunted from right heart to left
- blood bypass fetal lungs
14
Q
O2 sat of cyanotic presentation
A
- 80-85%
15
Q
acyanotic conditions
A
- atrial septal defect
- ventricular septal defect
- patient ductus arteriosus
- congenital aortic stenosis
- pulmonic stenosis
- coarctation of aorta
16
Q
cyanotic conditions
A
- truncus arteriosus
- transposition of the great vessels
- tricuspid atresia
- tetralogy of fallot
- total anomalous pulmonary venous return
17
Q
atrial septal defects caused by
A
- defect in septum between right and left atria
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
19
Q
result of delayed closing of pulmonic valve
A
- fixed split S2 murmor at upper left and right sternal borders
20
Q
atrial septal defects due to
A
- ostium secundum (most common)
- osmium primum
- sinus venosus
- patient foramen ovale
21
Q
ostium secundum defect
A
- due to inadequate formation of septum secundum or excessive resorption of septum primum
22
Q
ostium primum defect
A
- inferior portion of septum fails to fuse with endocardial cushion
23
Q
sinus venosus defect
A
- unroofing of area between pulmonary veins and RA
24
Q
patent foramen ovale
A
- persistence of foramen ovale
- atrial septa fail to fuse
- source of paradoxical emboli
25
how would a paradoxical emboli form
- DVT move from RA to LA
| - go into body/brain and block arteries
26
symptoms of ASD
- most usually asymptomatic
27
adults with ASD
- may have atrial tachyarrhythmia due to right atrial enlargement
28
percent of membranous ventricular septal defects
- 70%
29
percent of muscular ventricular septal defects
- 20%
30
VSD due to
- defect in septum that separates right and left ventricles
31
initial blood flow in VSD
- result
- left to right shunt
- pulmonary hypertension
- RV hypertrophy
32
later blood flow in VSD
- pressure RV > LV
- right to left shunt
- Eisenmeyer's syndrome
33
murmor in VSD
- harsh holosytolic murmur heart at lower left sternal border
34
pulmonary venous congestion due to
- left heart failure
35
pulmonary venous congestion symptoms
- tachypnea
- respiratory distress
- difficulty feeding
- cyanosis
- sweating
36
systemic venous congestion due to
- right heart failure
37
systemic venous congestion symptoms
- hepatosplenomegaly
| - edema/asites
38
PDA cause
- failure of ductus arteriosus to close
39
blood flow in PDA
- left to right shunt between aorta and pulmonary artery ]
| - decreased diastolic systemic perfusion
40
later result of PDA
- pulmonary hypertension reverses shunt
| - leads to Eisenmeyer's syndrome
41
murmor in PDA
- machine like murmur heard best at lower sternal border
42
PDA on CXR
- increased heart size
43
1st line treatment for PDA
- indomethacin
44
MOA of indomethacin
- prostaglandin synthesis inhibitor
45
symptoms of Eisenmeyer's
- cyanosis
- clubbing
- polycythemia
46
aortic stenosis most common in which gender?
- males
47
aortic stenosis cause
- narrowing of the aorta
48
result of aortic stenosis
- requires lots of LV pressure to pump blood
- left ventricular hypertrophy
- high velocity jet may cause dilation of proximal aorta
49
cause of pulmonic stenosis
- right ventricular outflow obstruction
| - abnormal formation/regression of subendocardial mesenchymal tissue
50
result of pulmonic stenosis
- impaired RV outflow
- increases RV pressure and RV hypertrophy
- may cause RV heart failure
51
coarctation of aorta due to
- narrowing of aortic lumen
52
theories of coarctation of aorta
- no flow no grow
| - ectopic ductal tissue
53
no flow no grow theory
- if blood doesn't flow to an area, that area won't develop as well
54
ectopic ductal tissue theory
- ectopic muscular tissue from ductus arteriosus constricts following birth
55
blood flow in coarctation
- less blood flows to lower limbs because of narrowing of valve
- more blood flows to upper limbs through greater branches of the aorta
56
result of coarctation of aorta
- BP of upper extremity is high
| - BP of lower extremity will be low
57
cause of persistent truncus arteriosus
- failure of truncus arteriosus to divide into pulmonary trunk and aorta
58
most patient with truncus arteriosus have
- accompanying VSD
59
symptoms of truncus arteriosus
- early cyanosis
| - patients have partially deoxygenated blood flowing through systemic circuit
60
cause of transposition of great arteries
- aorta leaves RV
| - pulmonary trunk leaves LV
61
what is the most common cause of neonatal cyanosis
- transposition of the great arteries
62
cause of TGA
- failure of aorticopulmonary septum to spiral in normal fashion
63
result of TGA
- 2 parallel circuits
| - most infants die without a shunt placed
64
cause of tricuspid atresia
- absent tricuspid valve
65
result of tricuspid atresia
- hypoplastic RV
66
what does tricuspid atresia require for viability
- ASD and VSD
67
most common form of early cyanotic congenital heart disease
- tetralogy of fallot
68
things found in tetralogy of Fallot (TOF)
- pulmonic stenosis
- right ventricular hypertrophy
- overriding aorta
- VSD
PROV
69
pulmonic stenosis in TOF causes
- right to left shunt leading to cyanosis
70
murmor heard in TOF
- left upper sternal border
71
CXR of TOF
- boot shaped heart
72
Tet spell with TOF
- dyspnea with exertion
73
how do kids reverse TOF Tet spell?
- squat to increase pressure on aorta
| - blood moves back to pulmonary artery then lungs
74
cause of total anomalous pulmonary venous return (TAPVR)
- pulmonary veins drain into right heart circulation instead of left heart
- going the opposite of what you would expect it to.
75
TAPVR associated with
- ASD +/- PDA to allow for right to left shunt to maintain cardiac output
76
cure for TOF
- early surgical repair
