Conginital Heart Disease Flashcards
What is the most common conginital heart disease
VSD
What are the risk factors for conginital heart disease
- Maternal conditions (DM, CTD, smoking, alcohol)
- radiation And medication
- chromosomal abnormqlities
Name the acyanotic conginital heart diseases
- LR Shunt (VSD, PDA, ASD, ECD)
- obstructive (AS, PS, COA, Ihss)
Name cyanotic heart diseases
- decrease blood flow: TOF, TA, PA, ebstein
- increased blood flow:D-TGA, TAPVD, S.v, TR.ar
Which one is more common
Acyanotic or cyanotic
Acyanotic
Pathophysiology of Left to Right shunt:
- Increase blood flow to pulmonary veins
- Increase pressure of the left side
- Tachypnea and tachycardia will increase heart size and caloric requirment and child will have developmental delay
When does signs appear after delivery for left to right shunt
4-6 weeks
What are the signs of left to right shunt?
- increased sweating (due to catacheloamines)
- shortness of breath (due to congestion of lungs)
- easy fatigue & prolonged interrupted feeding (increased caloric requirement)
- repeated chest infection
- failure to thrive
Where is the defect in the VSD?
Usually peri membranous
And can also be in the muscular side
What will you see during the examination of VSD?
- pansystolic murmur at the left lower sternum
- thrill (once the defect gets smaller)
How to diagnose VSD?
By echo
When and How to manage VSD?
Symptoms are not controlled
- surgery: ultimate tx.
- medical: for associated conditions “CHF, infection, nutrition, SBE Prophylaxis”
When is VSD usually close?
At 2 years of age
What is eisenmenger disease?
It’s the hardning of the pulmonary vasculature as a complication of VSD.
Where is ASD more common?
“Males or females”?
Females
Which area is more common to have the defect in ASD?
Septum secondum
Which disease is less likely to have symptoms of cyanotic heart diseases
ASD
What are the findings during examination of ASD?
Fixed splitting of second heart sound
What are the findings in ECG for ASD
RBBB or RAD
How to treat ASD?
Usually interventional. If the septum is way too large, we can wait for 4-6years and do surgery
When does ductus arterious close?
From 24hours to 2weeks
What is the murmur that is typically seen in PDA?
Continues machinery murmur at the base of the heart
Type of pulse in PDA
Bounding pulse with wide pulse
How to treat PDA?
Inteverntional coil like procedure
Atrioventricular canal is:
ASD in septum primum+ VSD + AV valave common
What is the most common congenital heart diseases in trisomies
Arterioventicular canal defect
Cushin defect
What is very special in endocardial cushin defect?
Left axis deviation in ecg
When to treat down syndrome patients with endocardial cushin defect
In the 4th or 6th month, because their pulmonary arteries tend to stenose earlier that any other
“Treat by surgery”
Where is the site of coarctaion of aorta?
At the isthmus “after the subclavian”
In which group of patients do we commonly see coarctation of aorta?
Turner syndrome
What is the key sign to observe that may indicate coarctation of aorta?
- Low BP + low/absent pulses in lower limb.
- HTN of upper limb
How to diagnose COA?
CT Angio + echo
How to treat COA?
Catheter with balloon “balloon vulvoplasty”
What are the causes of neonatal cyanosis
- Respiratory (aspiration of meconium, premature causing RDS, pneumothorax during induction)
- cardiac
- CNS (heavy sedation for mother, neuromuscular)
- methemoglobinemia
What is the work up for cyanotic neonates
1- history, ABG, CXR, pulse oximeter
2- hyperoxia
3- definite: echo
Mixing of venous and arterial blood will definitly cause
Cyanosis
What are the consequences of cynosis
- polycythemia (small due to iron) leading to CNS Complications
- clubbing
- thrombocytopenia and clotting leading bleeding disorder
- spells and squatting
- depressed intelligence
- scoliosis
- hyperurecemia and gout
