Cyanotic Heart Disease Flashcards
acrocyanosis
blue hands and feet
what is circumoral cyanosis
blue around the mouth
hyperoxitest: what is it
- check baselinearterial Po2 in room air
- give patient 100% O2 for 10 min
- recheck arterial PO2
- ->if pulmonary shows rise in PO2 to at least 100mgHg
- -> if heart right to left shunt will demonstrate no significant increase in PO2
Prostaglandin E1 -what for?
-only IV infusion to maintain patency of the ductus arteriosus
The 5 T’s - Cyanotic heart defects:
- truncus arteriosus
- transposition of the great arteries
- tricuspid atresia
- tetralogy of fallot
- total anomalous pulmonary venous return
_ASK PEOPLE ABOUT THING TO REMEMBER IT!
D-transposition is:
blue blood goes back out to body and red blood from lungs goes back to the lungs
(aorta arises from RV and pulomary trunk arises from LV)
D-transposition - gender prevalence?
-MALES
Fix for the D-transposition:
arterial switch + switch the coronaries
Tetralogy of Fallot (TOF)- what four issues?
- large ventricular septal defect
- aortic valve overrides vetrcular septum
- r ventricular outflow obstruction=tract is smaller bc septum anterior and to the right
- R ventricle hypertrophy
TOF- what makes the condition worse:
-the smaller the R ventricular outflow then the more R to left shunting = more blue
Tetralogy of fallot - history?
-cyanotic (become more blue as ductus arteriosus closes up after birth) and murmur hear at birth
Hypoxic tet spell - what condition? what happens?
- Tetralog of fallot
- peak incidence between 2 and 4 months
- sudden onset of rapid, deep breathing, irritability, prolonged crying, increased cyanosis, decreased heart murmur
- constriction of RV outflow tract (muscle spasm/smpathetic activation?)
Blalock Taussig shunt procesure is for?
how does it fix?
- for TOF
- replace PDA with something?
Tricuspid atresia
- tricuspid valve doesnt develop properly=RV doesnt dev properly
- small VSD often present
- majority have pulmonary atresia or stenosis
Tricuspid atresia on ECG?
LVH often! bc the left ventricle is really the only ventricle around!
Goal surgery for tricuspid or mitral valve atresia?
- fontan procedure (done after BT shunt procedure - allows for child/heart to grow a little) - systemic venous blood diverted directly to pulmonary arteries
- LV supports systemic circulation and the venous circulation goes straight into the lungs
truncus arteriosus
what hapens>
one great vessel leaves the heart conncted inbetween both ventricles (sits BW VSD) and out to both lungs and systemic circulation
least cyanotic disease?
truncus arteriosus
Total anomalous pulmonary venous retrun (TAPVR)
-whats going on here?
-pulmonary veins come back to heart but not the LA –> goes North or south to go to the RA! – ALL RED AND BLUE BLOOD MIXES IN RA
