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CVS > CVS 4 Congenital Heart Disease > Flashcards

CVS 4 Congenital Heart Disease Flashcards

1
Q

Causes of congenital heart diseases

A

Genetics
Environment- teratogenicity from drugs + alcohol
Maternal infections

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2
Q

What is teratogenicity?

A

Agent which causes malformation of embryo

e.g. drugs + alcohol whilst pregnant

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3
Q

What are some genetic conditions which have a higher chance of congenital heart disease?

A

Down’s syndrome
Tuner’s syndrome
Marfan’s syndrome

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4
Q

Two types of congenital heart defects

A

Acyanotic
Cyanotic

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5
Q

What is the shunt in acyanotic CHD?

A

Left to right shunt
Blood in system system fully saturated
pO2 is maintained

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6
Q

What is the shunt in cyanotic CHD?

A

Right to left
Blood mixing > deoxygenated blood in systemic circulation
Decrease in pO2

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7
Q

Physical presentation of cyanotic CHD?

A

Blue discolouration of skin + lips

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8
Q

What causes an atrial septal defect?

A
  • Opening in wall between atria - foramen ovale
  • Due to underdevelopment of septum primum or secundum
  • Hole between atria
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9
Q

What is caused by underdevelopment of septum primum or secundum?

A

Atrial septal defect

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10
Q

What is the shunt in ASD?
What is the effect?

A

L > R shunt
Increased pulmonary blood volume > damage to vasculature > resistance > pulmonary hypertension (rare) > pulmonary oedema due to fluid forced out
Right side heart failure

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11
Q

What can happen in ASD if pulmonary hypertension is left untreated?

A

RA pressure > LA pressure
R > L shunt
Mixing of blood - cyanotic
Eisenmenger’s syndrome

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12
Q

What causes a ventricular septal defect?

A

Primary interventricular foramen remains open
Septum doesn’t develop properly
Hole between ventricles

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13
Q

What is caused by undevelopment of the septum?

A

Ventricular septal defect

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14
Q

What is the shunt in VSD?
What is the effect if left untreated?

A

L > R shunt
Pulmonary hypertension
Right sided heart failure

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15
Q

What is the cause of an atrioventricular septal defect?

A

Failure of endocardial cushion development
Holes between atria + ventricles

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16
Q

What condition is AVSD common in?

A

Down’s syndrome

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17
Q

What CHD is common in Down’s syndrome?

A

Atrioventricular septal defect

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18
Q

What is the shunt in AVSD?

A

L > R shunt

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19
Q

What causes aortic/pulmonary stenosis?

A

Semilunar valves don’t develop properly - narrow when born

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20
Q

What is the common defect in the aortic valve in aortic stenosis?

A

2 leaflets instead of 3

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21
Q

What can aortic/pulmonary stenosis causes?

A
  • Heart has to work harder to push blood through stenosed valves
  • Ventricular hypertrophy
  • Heart failure
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22
Q

What is the cause of coartication of aorta?

A

Congenital narrowing of aorta

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23
Q

Common site of coartication of aorta

A

Ductus arteriosus area

24
Q

Presentation of coartication of aorta

A

Radial-femoral delay
Strong radial pulse
Weak femoral pulse

25
Q

Presentation of coartication of aorta if narrowing is between brachiocephalic + left subclavian artery

A

Radial-radial pulse delay
Delay in both wrists

26
Q

Effect of coartication of aorta

A
  • Increased pressure upstream
  • Increased risk of aneurysms of aortic arch
  • Increased risk of aortic root dilation > aortic valve regurgitation
27
Q

What is aortic valve regurgitation?

A

Aortic valve doesn’t close properly

28
Q

What is the cause of patent ductus arteriosus?

A

Ductus arteriosus remains open after birth

29
Q

What happens in PDA?
What are the effects?

A

Ductus arteriosus doesn’t close after first breath
Blood flows from aorta to PA - acyanotic
Increased volume in PA > increased afterload for RV
Right sided heart failure

30
Q

What is the cause of tricuspid atresia?

A

Tricuspid valve fails to form

31
Q

What is the effect of tricuspid atresia?
What other CHDs do babies with TA have?

A
  • Blood cant flow form RA > RV
  • Babies have ASD + VSD to allow blood into pulmonary circulation
  • ASD - R > L shunt of all venous return
  • VSD - allows blood into RV + out through PA
  • Blood mixing > central cyanosis
32
Q

What is the cause of pulmonary atresia?

A

Pulmonary valve fails to form

33
Q

What other CHDs are in babies with pulmonary atresia?

A

VSD - deoxygenated blood RV > LV
PDA - lows blood to pulmonary circulation

34
Q

What is given to newborns in transposition of great arteries before surgery to keep them alive?

A

Prostaglandins

35
Q

What causes transposition of great arteries?

A

Aorticopulmonary septum forms but doesn’t spiral
RV connected to aorta
LV connected to pulmonary artery

36
Q

What are the 4 defects in the tetralogy of fallot?

A

POSH
Pulmonary stenosis
Overriding aorta
Septal defect (ventricular)
Hypertorphy of RV

37
Q

Why is there hypertrophy of RV in tetralogy of fallot?

A

To compensate for stenosis in PA

38
Q

What causes a hypoplastic heart?

A

Underdevelopment of left ventricle
Due to mitral or aortic valve stenosis in utero

39
Q

Effect of hypoplastic heart

A

R > L shunt
cyanotic
Small ascending aorta if aortic valve is stenosed

40
Q

What CHDs are in patients with hypoplastic heart?

A

ASD + PDA
ASD - allow oxygenated blood to flow to PA
PDA - allows this blood into aorta to systemic system

41
Q

What causes univentricular heart?

A

Ventricular septum doesnt form at all

42
Q

What does failure of ventricular septum formation cause?

A

Univentricular heart

43
Q

What does underdevelopment of the left ventricle cause?

A

Hypoplastic heart

44
Q

What does the lack of spiralling of the aorticopulmonary septum cause?

A

Transposition of great arteries

45
Q

What does failure of pulmonary valve formation cause?

A

Pulmonary atresia

46
Q

What does failure of the tricuspid valve formation cause?

A

Tricuspid atresia

47
Q

What does failure of the ductus arteriosus closing after birth cause?

A

Patent ductus arteriosus

48
Q

What does narrowing of the aorta cause?

A

Coartication of aorta

49
Q

What does underdevelopment of the semilunar valves cause?

A

Aortic/pulmonary stenosis

50
Q

What does failure of the endocardial cushion development cause?

A

Holes between atria + ventricles
Atrioventricular septal defect

51
Q

What does underdevelopment of the septum cause?

A

Ventricular septal defects

52
Q

What condition occurs if the primary interventriclar foramen remains open?

A

Ventricular septal defects

53
Q

What defect is most likely if a newborn baby has continuous murmur + no signs of cyanosis?

A

Patent ductus arteriosus

54
Q

What defect is most likely if a newborn baby has a loud systolic murmur in left sternal border + no signs of cyanosis?

A

Ventricular septal defect

55
Q

List the acyanotic congenital heart defects

A
  • atrial septal defect
  • ventricular septal defect
  • atrioventricular septal defect
  • aortic/pulmonary stenosis
  • coartication of aorta
  • patent ductus arteriosus
56
Q

List the cyanotic congenital heart defects

A
  • tetralogy of fallot
  • tricuspid/pulmonary atresia
  • transposition of great arteries
  • uni ventricular heart
  • hypoplastic heart

CVS (20 decks)

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