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Cardiology > Congenital Heart Dz > Flashcards

Congenital Heart Dz Flashcards

1
Q

Atrial Septal Defect (ASD)

A

Opening in the atrial septum permitting free communication of blood btw the atria. Seen in 10% of all CHD.

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2
Q

Most common type of ASD

A

Secondum, at the fossa ovalis.
Followed by primum (lower) and
Sinus Venus (high in septum, rare)

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3
Q

ASD S/S

A

Most are asymptomatic
Rarely presents with CHF and CV S/S
Easy fatiguability, mild growth failure

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4
Q

ASD clinical findings

A

Hyperactive precordium, RV heave
Widely split S2
Systolic ejection murmor at LSB
Mid diastolic murmor over LLSB

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5
Q

Why are murmors heart with ASD?

A

Increased flow across the pulmonary valve (or tricuspid)

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6
Q

ASD Tx

A

Closure electively between ages of 2 and 5

Closure before age 25 shows best prognosis

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7
Q

Is endocarditis prophylaxis required for ASD?

A

No

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8
Q

Ventricular Septal Defect (VSD)

A

Abnormal opening in the ventricular septum

Accounts for 25% of congenital abnormalities

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9
Q

Most common type of VSD?

A

Perimembranous

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10
Q

Small VSD S/S

A

Small VSD usually asymptomatic
50% will close spontaneously by 2 yrs
Harsh holistic murmor on LSB

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11
Q

Severe VSD S/S

A

Harsh holosystolic murmor heard along LSB
Prominent PE, diastolic murmor
CHF, FTT, Resp infections, exercise intoleranceHyperactive precordium

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12
Q

Symptomatic VSD Tx

A

Medical tx with afterload reducers and diuretics

Surgical closure

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13
Q

Atrioventricular Septal Defect (AVSD)

A

Incomplete fusion of the endorcardial cushions

4% of all Congenital defects

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14
Q

What dz is AVSD more commonly seen in?

A

Downs syndrome

Seen in 25% of cases

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15
Q

Fixed split second sound =?

A

ASD

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16
Q

AVSD S/S

A 
CHF in infancy
Recurrent pulm infxns
Failure to thrive
Exercise intolerance
Late cyanosis from R to L shunt
Cardiac enlargement
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17
Q

AVSD Tx

A

Surgery is always required

Treat congestion

18
Q

Patent Ductus Arteriosis (PDA)

A 
Persistence of the normal fetal vessel that joins the PA to the Aorta
Normally closes in 1st week of life
Accounts for 10% of CHD
More females than males
Associated with coarctation and VSD
19
Q

PDA S/S

A 
Asymptomatic for small ones
CHF
Bounding arterial pulses
Widened pulse pressure
Enlarges heart
CLassic continuous machinary systolic murmor
20
Q

PDA Tx

A

Indomethican
Surgical closure
Need to prevent pulmonary vascular dz

21
Q

Which chambers are enlarged in VSD?

A

L and R ventricles and L atrium

22
Q

Pulmonary Stenosis

A

Obstruction in the region of the pulmonary valve or the subpulmonary ventricular outflow tract.
Accounts for 7-10% of CHD
Can present w/ or w/o intact ventricular septum

23
Q

What dz is pulmonary stenosis associated with?

A

Noonan’s Syndrome, secondary to valve dysplasia

24
Q

Pulmonary Stenosis S/S

A

Depends on severity
Split 2nd sound with delay
Heart failure and cyanosis in severe cases

25
Q

Pulmonary stenosis Tx

A

Stenosis relief
Balloon valvuloplasty
Surgical valvotomy is an option

26
Q

Aortic Stenosis

A

An obstruction of LV outflow at or near the aortic valve.
7% of CHD
Valvular is most common

27
Q

Which syndrome is Aortic stenosis found in?

A

WIlliams Syndrome

28
Q

Which chambers are enlarged in aortic stenosis?

A

LV and LA

29
Q

Aortic Stenosis S/S

A 
Exercise intolerance
CP, dyspnea, dizziness, syncope
Weak pulses, L sided heart failure
Sudden Death
Systolic thrill
30
Q

Aortic Stenosis Tx

A

Balloon Valvuloplasty is standard of tx

31
Q

Coarctation of the Aorta

A

Narrowing of the aorta.
98% are juxtaductal
3:1 males
7% of all CHD

32
Q

What other congenital abnormality is coarctation of the aorta seen in?

A

Bicuspid aortic valve (70% of cases)

33
Q

What genetic syndrome is coarctation of the aorta seen in?

A

Turner’s syndrome

34
Q

Coarctation S/S

A

Diminution or absent femoral pulses
Higher BP in arms than legs
90% of systolic HTN in upper extremities
Pulse discrepancy in rt and lt arms

35
Q

What will be seen on Xray with coarctation

A

rib notching and cardiomegaly

36
Q

Coarctation Tx

A

Prostaglandin E
Surgical intervention
Angioplasty

37
Q

Tetralogy of Fallot

A

Malignant VSD
Overriding Aorta
Pulmonic Stenosis
RVH

38
Q

Tetralogy Tx

A

Surgery…

39
Q

Transposition D-type

A

PA arises from LV
Aorta from RV
Cyanosis occurs
Prostaglandin given to keep ductus open

40
Q

L-Type Transposition

A

Heart is completely flip flopped
Works until late childhood
Many complications

41
Q

Ebsteins Anomoly

A

Atrialization of RV

Massive R atrium

42
Q

Ebsteins presentation

A 
Pediatric
Murmur
Atrial arrhythmias
cyanosis
R to L shunt

Cardiology (14 decks)

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