Congential Heart Defects

Question 1

What are cyanotic heart disorders?

Answer 1

R to L shunt, bypassing the lungs. Deoxygenated blood

Ex. Tetralogy of Fallot, Transposistion of great arteries, Truncus arteriosus

Question 2

What are acyanotic heart disorders?

Answer 2

L to R shunt, causes CHF

Ex. Atrial septal defect, Ventricular septal defect, Patent ductus arteiosus

Question 3

What is atrial septal defect (ASD)?

Answer 3

Small opening between atria
- Occurs when foramen ovale fails to close completely
- L to R shunt
- Usually asymptomatic

Question 4

What is ventricular septal defect (VSD)?

Answer 4

Opening between the ventricles
- Can cause CHF over time
- L to R shunt

Question 5

What is tetralogy of Fallot?

Answer 5

Defect that occurs from 4 anomolies:
1. VSD
2. Pulmonary artery stenosis
3. Overriding aorta
4. Right ventricular hypertrophy

Question 6

How do you treat Tetralogy of Fallot?

Answer 6

Can be mild to severe and can be managed surgically and prostaglandin E can be used to treat the PDA?

Question 7

What will tetralogy of Fallot look like in a CXR?

Answer 7

BOOT shaped (diagnosed with an echocardiography)

Question 8

Severe tets will be cyanotic and may experience…

Answer 8

• Tet spells
• Deep breathing
• Irritability
• Cyanosis
• Syncope

Question 9

What is Transposistion of the great vessels?

Answer 9

• R to L shunt
• Pulmonary artery & aorta are transposed (switched)
• Prostagladins should be given to maintain a PDA. Balloon atrial septosomy may be necessary.
• Presenst with moderate to severe cyanosis at birth. CXR will show egg-shaped heart
• Surgical correction is necessary
• O2 will not improve cyanosis

Question 10

What is coartion of the aorta?

Answer 10

• Severe narrowing of the aorta near the ductus arteriosus
• May increased the afterload to the heart, causing pulmonary edema, myocardia ischemia and CHF
• Systemic blood flow relies on a PDA
• Neonates with severe coartction will require prostaglandin E1 to maintain a PDA until surgical correction

Question 11

What is Truncus arteriosus?

Answer 11

The aorta and pulmonary artery share one outflow tract. A large VSD allows mixing of oxygenated & deoxygenated blood.

Question 12

What is the treatment for truncus arteriosus?

Answer 12

Surgical correction

Question 13

What is hypoplastic lung syndrome?

Answer 13

Abnormal development of the left heart structures.

Question 14

What is the traetment for hypoplastic left heart syndrome?

Answer 14

• Prostaglandin E1 for PDA & surgical correction.
• O2 (<21%) to increase PVR & maintain blood flow

Question 15

What is hypoxic ischemic encephalopathy (HIE)?

Answer 15

Brain injury due to lack of blood flow to the brain before, during, or after childbirth.

Question 16

What is the treatment for HIE?

Answer 16

Therapeutic hypothermia
Ex.
- Total body cooling (requires special blanket)
- Selective head cooling wraps the infants head only
- Passive cooling: removing external heat sources from newborn
- Active cooling - servo controlled blanket to cool child