CVS - Cyanotic HD Flashcards
Tetralogy of Fallot components
- VSD
- Overriding of aorta
- Pulm valve stenosis
- RV hypertrophy
Tetralogy of Fallot c/f
- mcc of congenital cyanotic HD in children
- Symptoms may start after few months of birth
- SQUAT to ↓Rt to lt shunt
- Cyanotic spells
- Dyspnoea on exertion
- TET SPELLS - paroxysmal hypercyanotic attacks
●Activity … cyanosis, gasping, syncope
●Mx- Knee to chest position, O2, morphine, B-blocker - Ejection systolic murmur (OR) Only S2
Tetralogy of Fallot inv
CXR - BOOT SHAPED HEART
ECG - RV hypertrophy
Best - ECHO
Tetralogy of Fallot rx
Cyanotic at birth - PGE1 … to keep DA patent
Sx repair 4-12months (Blalock taussig shunt)
TGA Transposition of great arteries
- Mcc cyanotic HD immediately after birth
- > > in mothers with DM
- Aorta arises from RV
Pulm artery from LV .. immediate cyanosis - No murmurs
- If alive = PDA or foramen ovale +
- Rx - PGE1 to keep PDA
Atrial switch sx
TGA inv
CXR - EGG ON STRING appearance
ECG - normal
Best - ECHO
Hypoplastic left heart syndrome
- Atresia of LV, MV, aortic valve, ascending aorta
- RT heart takes care of pulm and systemic supply
- Foramen ovale/ASD+ … mixing of blood .. PDA
- Cyanosis +/- till 3-4 days
Dxt: if ductus arteriosus closes (in 3-4days) …severe cyanosis - RV hypertrophy … RHF
Hypoplastic left heart syndrome inv
CXR - enlarged heart, ↑pulm blood flow
ECG - RVH, RA enlargement, decreased lt sided forces
Best - ECHO
Hypoplastic left heart syndrome rx
three stage NORWOOD procedure
*Innocent murmurs
In >12months
- Soft - low amplitude
- Sweet - not harsh
- Systolic
- Single - no clicks/gallops
- Short duration
- Sensitive - changes with position
- Small - small area over chest, non-radiating
4 Criteria to dxt:
1. No symptoms
2. No fam h/o cardiac structural abn
3. No abn physical findings
4. Auscultation murmur - 7 S
CXR, ECG - cannot help
Refer to cardio > ECHO
Innocent murmur at 12 months
Can dxt as innocent murmur
<12months - refer
