Congenital Heart Disorders Flashcards
which disorders are cyanotic?
- Tetraology of Fallot
- Hypoplastic LH syndrome
- Transposition of the Great Vessels
- Pulmomary Atresia
which disorders are acyanotic?
- atrial septal defect
- ventricular septal defect
- patent ductus arteriosus
- coarctation of the aorta
Transposition of the Great Vessels
what is it?
R side (deoxy blood) pumps out to body while L side (oxy blood) pumps back into lungs
Transposition of the Great Vessels
presentation
- cyanosis/breathing probs
- poor feeding
Transposition of the Great Vessels
PE findings
- weak pulse
- ashen/blue skin
- systolic murmur
Transposition of the Great Vessels
tx
- abort
- arterial switch operation
Hypoplastic Left Heart Syndrome
what is it?
L side of heart fails to develop
Hypoplastic Left Heart Syndrome
sx
- shock
- cyanosis
- variable murmur
Hypoplastic Left Heart Syndrome
tx
3 stages of surgery
* Norwood (first 2wks of life)
* bi-directional glenn shunt (4-6 mo)
* Fontan (18 mo to 3 yrs)
Hypoplastic Left Heart Syndrome
tx if not eligible for 3 surgical steps?
transplant
Pulmonary Atresia
describe
pulm valve did not form, no flow from RV to pulm artery
Pulmonary Atresia
presentation
- cyanotic, blue
- variable murmur
- hyperdynamic apical impulse
Pulmonary Atresia
tx
- rx to keep PDA open
- usually stent PV or patch VSD
Tetralogy of Fallot
describe
- VSD
- pulm stenosis
- RVH
- overriding aorta
Tetralogy of Fallot
presentation
- cyanosis
- polycythemia
- agitation
Tetralogy of Fallot
describe the murmur
crescendo-decrescendo holosystolic LSB radiate to back
Tetralogy of Fallot
PE findings
5
- clubbing
- tet spell (randomly passes out)
- squatting
- boot shaped heart
- nail clubbing
Tetralogy of Fallot
dx & tx
- echo
- surgical repair
Ventricular Septal Defect
most common of all congenital heart defects
just a fun fact…
Ventricular Septal Defect
sx
- weakness
- fatigue
- poor feeding
- DOE
- failure to thrive
Ventricular Septal Defect
describe the murmur
- loud, high pitched
- harsh
- holosystolic M LLSB
- does not change w/ positioning
Ventricular Septal Defect
dx
echo
Ventricular Septal Defect
tx
- surgery
- wait until > 35 lbs
Patent ductus arteriosus
describe
fails to close after birth, so oxygenated blood flows from aorta into pulm arteries back to lungs
Patent ductus arteriosus
tx?
indomethacin
Patent ductus arteriosus
presentation
- wt loss w/ poor feeding
- pulmonary congestion
- frequent pulmonary infections
Patent ductus arteriosus
murmur
continuous machinery murmur
Atrial Septal Defect
describe
hole between L and R atriua
Atrial Septal Defect
what is eisenmenger syndrome
- R to L shunting (deoxygenated blood dilutes oxygenated blood
Atrial Septal Defect
suspect this if pt has what?
cryptogenic stroke
Atrial Septal Defect
presentation
- frequent resp or lung infections
- difficulty breathing
- tiring when feeding
- SOB w/ exertion
- heart skips beats
- edema
- stroke
Atrial Septal Defect
murmur description
- systolic 2nd LICS
- rumbling
- RV heave
Atrial Septal Defect
dx
- echo (bubble study)
Atrial Septal Defect
surgery options
- closure device
- open surgical repair
Coarctation of Aorta
THIS IS AN EMERGENCY
just remember it…
Coarctation of Aorta
describe
the descending proximal thoracic aorta is narrowed
Coarctation of Aorta
presentation
5
- pale skin
- irritable
- diaphoresis
- difficulty breathing
- HTN
Coarctation of Aorta
describe murmur
- LUSB continuous, radiates to back
Coarctation of Aorta
what is pathognomonic for this?
difference between upper and lower extremity pulses/BP
Coarctation of Aorta
dx
- CXR: rib notching & 3 sign
- Angiogram (gold standard)
Coarctation of Aorta
tx
balloon angioplasty +/- stent
surgical repair
Coarctation of Aorta
what do these pts usually also have?
bicuspid aortic valve
tx of POTS (non medical)
- SALT!
- caution w/ position changes
- compression hose
- exercise
medical tx of POTS
- metoprolol
- fludrocortisone
- midodrine
