CVS - Acyonotic HD Flashcards
Shunts in fetal circulation
- Foramen ovale - RA and LA,
closed after birth - Ductus arteriosus - Aorta and pulm artery,
closed 1-2days of birth - Ductus venosus - umblical vein, liver, RA
Acyanotic vs cyanotic heart disease
- Acyanotic - septal defects
VSD, ASD, PDA, Coarctation of aorta - Cyanosis can happen
- Left to right shunt
VSD pathophysio
Mc associated with Downs and klinefelter
1. MCC congenital cardiac lesion
2. Blood: LV to RV..
LEFT TO RIGHT SHUNT …
RV hypertrophy …
↑RV pressure
RIGHT TO LEFT SHUNT… cyanosis
EISENMENGER SYNDROME
RV fail - HF symptoms - poor feeding, poor wt gain, tachypnoea
- Pansystolic, harsh murmur @lower sternal border
Mx of VSD
- Initial: CXR, ECG
Best inv: ECHO - RX:
Small defect - spontaneous closure 1-2yrs
Mod-large - Sx
ASD
- 2nd Mc congenital cardiac lesion
- Patho similar to VSD
- Murmur:
●Small- Ejection systolic @mid-upper left sternal border (↑ pulm flow)
●Large - Diastolic rumble @lower sternal border - Initial: CXR, ECG - RVH, Right axis deviation
Best inv: ECHO - Spontaneous resolution
Can be asymptomatic till 30s
Symptomatic - Sx
PDA pathophysio
- Girls, Cong rubella, premature baby
- Blood: aorta to pulm artery..
PULM HTN
RVH - *MACHINERAY continuous MURMUR - large defect
Asymptomatic - small defect
Wide pulse pressure
Bounding artery pulses
PDA Mx
- Initial: CXR, ECG
Best inv: ECHO - Spontaneous closure
INDOMETHACIN (PG inhibitor)
-PGs help in keeping DA open
Sx
Coarctation of aorta pathophysio
mc associated with Turners
1. Narrowing of aorta, mainly below lt subclavian branch
… ↑blood in brachiocephalic, lt carotid, subclavian arteries …
RADIO-FEMORAL DELAY
RADIO-RADIO DELAY - ↑blood to lt arm than rt arm
=DIFFERENTIAL CYANOSIS
- Systolic pressure:
arms > leg more than 5% (normally legs > arm)
Lt arm > rt arm
Coarctation of aorta Mx
- Initial:
CXR - inferior notching of ribs
ECG - Best: ECHO
Rx:
●Keep ductus arteriosus patent - PGE1 (to ↑blood to LL minimally)
●Sx