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Question 1

Define ventricular septal defects

Answer 1

An abnormal opening in the interventricular septum

Question 2

Describe ventricular septal defects

Answer 2

– usually occurs in the membranous portion of the septum- BLOOD FLOW from left to right due to pressure gradient – acyanotic– 25% of all congenital heart defects

Question 3

What can ventricular septal defects cause?

Answer 3

1. LV hypertrophy as LV volume is overloaded2. Pulmonary hypertension after pulmonary venous congestion3. Pneumothorax4. Dyspnoea5. Pulmonary oedema

Question 4

Define atrial septal defect

Answer 4

An abnormal opening in the septum between the two atria which persists following birth

Question 5

Describe atrial septal defect

Answer 5

Foramen ovale fails to close in majority of casesCauses L to R flow – acyanotic

Question 6

Define patent foramen ovale

Answer 6

Foramen ovale fails to close properly – higher LA pressure tends to close gap so patients are asymptomatic

Question 7

What are the four anomalies found in tetralogy of fallout?

Answer 7

Ventricular septal defectOverriding aortaPulmonary stenosisRight ventricular hypertrophy

Question 8

What are the main effects of tetralogy of fallot?What determines the severity?

Answer 8

Pulmonary stenosis – persistent right ventricular hypertrophy as higher pressure os needed to pump bloodCyanosis due to VSD and OA causing R to L shunting. Severity of pulmonary stenosis

Question 9

What are the symptoms of tetralogy of fallot?

Answer 9

Low blood O2Difficulty with eatingFailure to weight gainRetarded growth”Tet spells” – marked increase in cyanosis followed by syncope. Can cause brain injurt and death

Question 10

Define tricuspid atresia

Answer 10

Lack of development of the tricuspid valve so there is no inlet into the right ventricle– R to L atrial shunt– Ventricular septal defect allows flow to lungs– is incurable as can’t replace ventricles

Question 11

Define transposition of the great arteries and give its cause

Answer 11

Two unconnected parallel circuits instead of oneCaused by conotruncal septum not adopting a spiral course

Question 12

Describe transposition of the great arteries

Answer 12

RV connected to aorta. LV connected to pulmonary artery – causes major cyanosis(deoxygenated blood continues in systemic circulation and oxygenated blood continues in pulmonary circulation)

Question 13

What is the treatment for transposition of the great arteries?

Answer 13

– need communication as fetus will not be viable– surgery is required straight after birth

Question 14

Define total anomalous pulmonary venous drainage

Answer 14

ll 4 pulmonary veins drain into the vena cava or the right atrium causing systemic and venous blood to mix in the right atrium.

Question 15

What is univentricular heart?

Answer 15

Both the atria drain into one ventricle.

Question 16

What is hypoplastic left heart?

Answer 16

LV and ascending aorta fail to develop properly. Is lethal without surgery

Question 17

What does hypoplastic left heart cause?

Answer 17

Underdeveloped left ventricleSmall ascending aortaRV supports the systemic circulation via patent foramen ovale or atrial septal defect

Question 18

Define stenosis

Answer 18

abnormal narrowing of a blood vessel

Question 19

Define atresia

Answer 19

absence of abnormal closure of blood vessel

Question 20

What is aortic stenosis?

Answer 20

Abnormal narrowing of aortic valve

Question 21

What are the effects of aortic stenosis?

Answer 21

Valve leaflets are stiff, leads to reduced systolic opening and increased left ventricular pressure.

Question 22

What are the symptoms of aortic stenosis?

Answer 22

Exercise induced anginaSyncopeHeart failure – due to ischaemia of LV myocardium

Question 23

Define aortic atresia

Answer 23

no left ventricular outlet causing impeded blood flow. The only source of blood flow is via a patent ductus arteriosus

Question 24

Define pulmonary stenosis

Answer 24

Abnormal narrowing of pulmonary valve

Question 25

What are the effects of pulmonary stenosis?What causes it?

Answer 25

– RV systole is obstructed, so RV and RA become hypertrophied – tends to be due to a congenital lesion (rubella)

Question 26

What are some symptoms of pulmonary stenosis?

Answer 26

fatigue, syncope and right heart failure

Question 27

Define pulmonary atresia

Answer 27

No right ventricular outlet is present

Question 28

What are the effects of pulmonary atresia?

Answer 28

–R to L shunt of the entire venous system and blood flow to the lungs occurs via a patent ductus arteriosus

Question 29

Define patent ductus arteriosus

Answer 29

Ductus arteriosus does not close and is present after birth. – connects pulmonary artery to the aorta in the fetus

Question 30

When should the ductus arteriosus close?

Answer 30

After birth, when the lungs receive oxygen and the pressure in the pulmonary artery drops

Question 31

What are the effects of a patent ductus arteriosus?

Answer 31

Causes L to R shunt– large shunt can lead to pulmonary hypertension, vascular remodelling of the pulmonary circulation and increased pulmonary resistance.

Question 32

Define Eisenmenger syndrome

Answer 32

Increased pulmonary resistance can lead to the shunt reversing if pressure is greater than systemic pressure

Question 33

Define coarctation of the aorta

Answer 33

Is a narrowing of the aortic lumen where the ductus arteriosus inserts.

Question 34

What are the effects of coarctation of the aorta?

Answer 34

– Increases the after load (tension developed in the wall) of the LV – Causes left ventricular hypertrophy (heart has to pump harder to reach the same outflow)– Blood flow to lower body and trunk is reduced (vessels emerge from heart distal to coarctation)– Blood flow to head and neck not affected as they leave proximal to coarctation.

Question 35

What are the symptoms of coarctation of the aorta?

Answer 35

– babies can be born with signs of heart failure in severe cases. – mild cases can be detected in adult life.– femoral pulses are weak and delayed and there will be upper body hypertension.