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Congenital Heart Defects > Endocardial Cushion Defects > Flashcards

Endocardial Cushion Defects Flashcards

http://emedicine.medscape.com/article/154823-overview

1
Q

ECDs can be ____ or ____. (Categories of ECDs)

A

partial, complete

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2
Q

Cause of ECDs

A
  1. endocardial cushions don’t grow convex toward IAS, and concave toward IVS
  2. endocardial cushions don’t grow at all and not in right direction
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3
Q

Complete ECD (AV Canal) involves all 4 ____ in all 4 ____.

A

valves, chambers

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4
Q

The term ECD and ____ ____ are interchangeable.

A

AV Canal Defect

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5
Q

Endocardial cushions normally grow ____ toward the interatrial septum.

A

convex

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6
Q

Endocardial cushions normally grow ____ toward the interventricular septum.

A

concave

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7
Q

If the endocardial cushions do not grow correctly, there isn’t any ____ to meet the ____ and ____.

A

tissue, IVS, IAS

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8
Q

ECDs are associated with patients with ____ abnormalities as well.

A

neurological

EX: Downs Syndrome

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9
Q

The atrial septal defect ____ ____ can also be classified as an endocardial cushion defect.

A

ostium primum

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10
Q

endocardial cushions help form:

A
  1. part of the interatrial septum
  2. interventricular septum
  3. medial/septal leaflet of tricuspid valve
  4. anterior leaflet of the mitral valve
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11
Q

With a complete ECD, there is a large ____ ____ and a large ____ ____.

A

membranous VSD, primum ASD

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12
Q

With a complete ECD, the ____ & ____ can be merged.

A

MV, TV

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13
Q

Physical findings of a patient with complete ECD:

A

cyanotic / blue color around lips and eyes

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14
Q

How would you describe the shunting with a complete ECD?

A

Shunting at both levels

Swirling of venous and arterial blood

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15
Q

____ ____ is a lesion associated with complete ECD.

A

Aortic Insufficiency

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16
Q

Other associated defects with complete ECD:

A
  • other septal defects
  • cleft mitral valve
  • fenestrations in both septum
17
Q

A Partial ECD is due to the endocaridal cushions partially ____.

A

fuse

18
Q

What happens to the right atrium with a partial ECD?

A
  • dilation
  • hyperdynamic
  • increase in muscle mass
  • tricuspid regurge
  • eisemnenger’s syndrome
19
Q

Heart sounds with a complete ECD?

A
  • fixed/split S2 (A2 and P2) (because of the big common ventricle and dilated atria)
20
Q

With a complete ECD, there is a palpable thrill over the ____, due to a volume overload through that vessel.

A

pulmonary artery

21
Q

In extreme cases of ECD, infants suffer from ____ ____ ____.

A

failure to thrive

22
Q

Signs and symptoms of infants with complete ECD:

A
  • fatigue
  • weakness
  • shortness of breath
  • dyspnea
  • growth retardation
  • cyanosis
23
Q

The volume overload in complete ECD, there is ____ due to increased volume to the pulmonary vascular bed and increased pulmonary vascular resistance.

A

PHTN

24
Q

maintaining normal ____ ____ is difficult in patients with complete ECD.

A

blood pressure

25
Q

When an infant cannot go directly into surgery to correct a complete ECD, ____ is performed as a palliative measure until the baby is ready to have surgery.

A

PA banding

26
Q

PA banding decreases narrows the diameter of the pulmonary artery, thus decreasing the ____ ____.

A

flow rate

27
Q

If ECD is not repaired within the first year of life, there is an ____% mortality rate, due to CHF and pulmonary vascular disease.

A

80%

28
Q

The primary goal for the surgical repair of ECD:

A

restore normal blood flow to the system by surgically closing the ASD and VSD with patches

29
Q

The normal procedure during surgery for the correction of ECD:

A
  1. Reconstruct or replace mitral and tricuspid valves
  2. Make sure LVOT and RVOT are not obstructed
  3. Close ASD and VSD with patches
  4. Remove PA band
  5. Repair any other defects
30
Q

Factors that need to be addressed before taking an infant into surgery:

A
  • term of pregnancy
  • gestational age
  • function of lungs
31
Q

With partial ECD, why do the TV and MV sit lower in the chamber?

A

Because of the large VSD

Congenital Heart Defects (19 decks)

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