CVS 6 - Congenital Heart Disease

Question 1

What does aetiology mean?

Answer 1

The causation of a disease or condition

Question 2

Give some causes of congenital heart disease

Answer 2

• GENETIC (Down’s, Turner’s, Marfan’s)
• ENVIRONMENTAL (teratogenicity from drugs, alcohol etc)
• MATERNAL INFECTIONS (Rubella, Toxoplasmosis etc)

Question 3

What is the percentage O2 saturation in the right side of the heart?

Answer 3

60%

Question 4

What is the percentage O2 saturation in the left side of the heart?

Answer 4

99%

Question 5

What are the two classifications of congenital heart disease?

Answer 5

Cyanotic and acyanotic

Question 6

Give some examples of acyanotic defects

Answer 6

Aortic stenosis, pulmonary stenosis, coarctation of the aorta, mitral stenosis

Question 7

Give some examples of cyanotic defects

Answer 7

• tetralogy of Fallot
• transposition of the great arteries
• total anomalous pulmonary veinous drainage
• univentricular heart

Question 8

What are the haemodynamic effects of atrial septal defects?

Answer 8

• increased pulmonary blood flow
• right ventricle volume overload
• pulmonary hypertension (rare)
• eventual right heart failure

Question 9

What are the haemodynamic effects of ventricular septal defects?

Answer 9

• left to right shunt
• right ventricle volume overload
• pulmonary venous congestion
• eventual pulmonary hypertension

Question 10

What is coarctation?

Answer 10

Congenital narrowing of a short section of the aorta

Question 11

What is tricuspid atresia?

Answer 11

This occurs when there is no right ventricle inlet, so there is a right to left atrial shunt of the entire venous return. Blood flow to lungs flows via a ventricular septal defect.

Question 12

What is hypoplastic left heart?

Answer 12

The left ventricle is underdeveloped, and the ascending aorta is very small. The right ventricle supports the systemic circulation. There is an obligatory left to right shunt.

Question 13

What is transposition of the great arteries?

Answer 13

This occurs when the right ventricle is connected to the aorta, and the left ventricle is connected to the pulmonary artery. This is not viable unless the two circuits communicate via shunts.

Question 14

What is a univentricular heart?

Answer 14

Occurs when the ventricular septum does not form properly and leads to there being one large ventricle instead of two

Question 15

What is pulmonary atresia?

Answer 15

Heart with no right ventricular outlet, so there is a right to left atrial shunt of entire venous return. Blood flows to lungs via PDA

Question 16

What are the symptoms of atrial septal defects and when do they occur?

Answer 16

Usually asymptomatic late into adulthood. Late onset arrhythmia and right heart failure

Question 17

What are the symptoms of ventricular septum defects and when do they occur?

Answer 17

Usually present in infancy with left heart failure. If left untreated, can lead to inoperable pulmonary hypertension

Question 18

What are the symptoms of coarctation?

Answer 18

Adult variety has renal hypertension, left ventricular hypertrophy and often aortic valve stenosis

Question 19

What are the symptoms of tetralogy of Fallot and when do they occur?

Answer 19

Present in infancy or early childhood with cyanotic spells. Only mild cases make it to adulthood.