CVS Tute 1

Question 1

Common Congenital heart defects

Answer 1

Common Congenital Defects:

ASD: Resulting from malformation of the Septum Primum or septum Secundum. Failure to close/failure to develop all the way through the Intra-atrial septum area.

VSD: Results from defects of endocardial Cushions

Persistent truncus Arteriosus: Defects in truncoconal cushion, failure of the aorticopulmonary septum to develop properly

Tetralogy of Fallot: conotruncal, endocardial cushions

Persistent Ductus Arteriosus: failure of it to close off

Transposition of the great vessels: failure of Truncus Arteriosus to divide properly (conotruncal suchions)

Persistent AV canal: endocardial cushions

Question 2

Diagnosis of HTN

Classification

Answer 2

Diagnosis of what constitutes HTN depends on the whole clinical picture: taking into account co-morbidities, and other patient factors. HTN should be treated at the point where the benefits of treatment, for the individual, outweigh the risks of treatment.

In general terms, hypertension is classified as systolic >139 and diastolic >89. HTN cannot be diagnosed from a one-off reading. There must be persistently high BP readings for diagnosis. 24h ambulatory or regular BP checking is required.

Classification:

Essential (95%) and Secondary (5%)

Essential HTN occurs from a range of interacting factors: including genetic factors such as inappropriately active renin-angiotensin system, abnormal reabsorption of Na+, etc. Other factors include lifestyle factors such as obesity, smoking, stress, etc.

Secondary HTN occurs secondarily to a specific, identified, underlying pathology