Congenital Heart Diseases

Question 1

Ventricular Septal Defect (VSD)

Answer 1

• Left to Right shunt
• hole in the septum between left and right ventricles results in increased pulmonary blood flow
• loud, harsh murmur
• heart failure
• many close early in life

Question 2

Atrial Septal Defect (ASD)

Answer 2

• Left to right shunt
• hole between left and right atria that results in increased pulmonary blood flow
• loud, harsh murmur
• heart failure

Question 3

Patent Ductus Arteriosus

Answer 3

• the normal fetal circulation conduit between pulmonary artery and aorta fails to close resulting in increased pulmonary blood flow
• systolic murmur (machine hum)
• wide pulse pressure
• bounding pulses
• fast breathing, breathlessness

Question 4

Pulmonary Stenosis

Answer 4

• Narrowing of pulmonary valve that results in obstruction
• systolic ejection murmur
• cyanosis varies with severity
• heart failure
• high pressure load

Question 5

Aortic Stenosis

Answer 5

• Narrowing of aortic valve
• infants: faint pulses, hypotension, tachycardia, poor feeding tolerance
• children: intolerance to exercise, dizziness, chest pain
• decreases blood flow to ENTIRE body

Question 6

Coarctation of the Aorta

Answer 6

• narrowing of lumen of aorta usually at or near ductus arterioles. results in obstruction of blood from ventricle
• elevated BP in arms (remember BP in infants equal in all 4 extremities)
• bounding pulses in upper extremities
• weak or absent femoral pulses

Question 7

Aortic Stenosis vs Coarctation of the aorta

Answer 7

• Aortic stenosis: narrowing of aorta occurs earlier dow on aorta resulting in decreased blood flow to ENTIRE body
• Coarctation of aorta: narrowing of aorta occurs lower down on aortic arch, allowing blood flow to brain and upper extremities

Question 8

Tricuspid Atresia

Answer 8

• complete closure of tricuspid valve that results in mixed blood flow
• deoxygenated blood entering systemic circulation, no blood going to lungs
• right to left shunt
• nowhere for the blood to go results in right sided heart failure over time
• infants: cyanosis, dyspnea, tachycardia
• children: clubbing of the fingers

Question 9

Tetralogy of Fallot

Answer 9

• 4 defects that result in mixed blood flow: pulmonary stenosis, ventricular septal defect, overriding aorta, right vent hypertrophy
• decreased pulmonary blood flow
• results in: cyanosis at birth: progressive cyanosis over first year of life, systolic murmur

Question 10

Two congenital heart defects that DECREASE pulmonary blood flow

Answer 10

1. Tetralogy of Fallot

2. Tricuspid Atresia

Question 11

Transposition of Great Arteries

Answer 11

• Aorta connected to right ventricle instead of let ventricle and pulmonary artery connected to left ventricle
• cyanosis, poor feeding, blue or purple tint to lips, skin, nails
• mixed blood flow

Question 12

Hypoplastic Left Heart Syndrome

Answer 12

• underdeveloped left side of heart. An ASD or patent foramen oval allows for oxygenation. Once PDA closes more cyanosis
• no oxygen rich blood going out to the body
• gradually turn blue overtime as tissues of body die as a result of poor perfusion and oxygenation

Question 13

truncus arteriosus

Answer 13

• Failure of septum formation resulting in single vessel off the ventricles. The oxygen-poor blood from the right vent and the oxygen-rich blood from the left vent mix when ejected out into the trunk, more blood than normal goes back to the lungs
• Cyanosis, HF, trouble feeding, delayed growth, cardiomegaly, weak pulses, dyspnea, weak cry, profuse sweating
• usually have a VSD

Question 14

TtGT vs HLHS at birth

Answer 14

TtGT blue at birth, HLHL is a gradual turning blue type bit