congenital heart diseases Flashcards
where is the ostium primum ASD
inferior portion of the IAS
how is an ostium primum asd formed
when the septum primum fails to fuse with the endocardial cushion during septation
associated anomalies with the ostium primum ASD
malformed mitral valve
what is ostium secundum ASD
mid portion of the IAS
what is the most common ASD
ostium secundum
sinus venosus asd
near the SVC superior portion of the IAS
what anomalies are associated with sinus venosus asd
partial pulmonary venous return (PV’s do not return to the LA)
where is a coronary sinus ASD
inferior portion of IAS close to coronary sinus
common atria
absence of near absence of the IAS
normal Qp/Qs ratio is
1/1 or 1
a small shunt ratio
1.5/1
a moderate shunt ratio
2/1
a large shunt ratio
> 2/1
what is the ratio when a shunt is RIGHT TO LEFT
less than 1
the shunts direction depends on what ?
the PVR and SVR
or
pulmonary vascular resistance and systemic vascular resistance
when a shunt becomes right to left that is called
eisenmengers syndrome
eisenmengers syndrome can lead too
cyanosis
how to calculate the shunt ratio
CSA used to calculate the shunt ratio
.785
FVI is
the VTI
the distance the blood travels with each stroke
inlet VSD is
by the MV and TV
associated w/ atrioventricular septal defect
muscular or trabecular VSD location
usually low on the septal wall, in the thicker more muscular portion close to the apex
a muscular VSD gives the appearance of what
swiss cheese
outlet VSD location
between LVOT and RVOT
the outlet VSD is associated w/
AV prolapse and AI
membranous/perimembranous vsd location ..
bordered by TV and AOV
high in the septal wall in the thinner, more flexible portion of the septum
mal-alignment of the septum vsd
2 portions of the IVS have failed to align properly during development
carcinoid disease echo findings
- fixed and rigid TV
- TR
- PI
- right heart failure
vsd direction equation
(.782)(rvot diameter)^2 x (rvot planimeter pwd) / (.785 lvot diameter^2) x (lvot planimeter pwd)
what kind of murmur is a PDA
a continuous high pitched murmur
why after birth a pda blood moves from aorta to pulmonary artery
the SVR is greater than the PVR
endocardial cushion defect combination of congenital anomalies
a hole in the center of the heart
a common valve
what trisomy is assoc. w/ endocardial cushion defecf
21
endocardial cushion defect symptoms
cyanosis
dyspnea
fatigue
murmur
poor appetite and weight gain
coughing, wheezing, swelling
cleft mitral valve most commonly affect which leaflet
anterior
cleft mitral valve associated lesions
ASD
AVSD
MVP
PDA
VSD
valvular pulmonic stenosis
stenosis of the cusps
most common cause of valvular PS
congenital
sub valvular PS
stenosis of the RVOT
pulmonic valve continuity equation
(VTI RVOT) x CSA RVOT / VTI PV
mild PS PG
<36 mmhg
severe PS PG
> 64 mmhg
with aortic coarctation where is the BP higher
the upper extremities
where does an aortic coarctation occur
AO ithmus
the result of a LARGE RA from ebstein anomaly can cause
PFO
small RV
TR
and Right sided HF
ebsteins anomaly is usually associated w/
ASD
VSD
PFO
PDA
PS
MS
TET. OF FALLOT
TETRALOGY OF FALLOT 4 DEFECTS
- OVER RIDING AORTA
- RVH
- VSD
- PS
CHILDREN with tetralogy of fallot usually experience what
exercise intolerance
squat spells
episodes of cysnosis and faintness
Dextro TGA
the pulmonary artery and the aorta are switched
levo TGA
the anatomic right and the anatomic left ventricles are switched
