EXAM 3 CARDIO Flashcards
Cyanotic classification of heart defects
Decreased pulmonary blood flow
Mixed blood flow
Acyanotic classification of heart defects
Increased pulmonary blood flow
obstruction to blood flow from ventricles
Describe Atrial Septal Defect
Increased pulmonary blood flow (acyanotic)
LA pressure greater than RA, so blood flows through abnormal opening in the atrial septum which distends the RA. RV tolerates well although there may be some hypertrophy after several decades.
Pt is usually asymptomatic and often spontaneously close in first year of life.
Describe Ventricular Septal Defect
Increased pulmonary blood flow (acyanotic)
Hole in ventricle septum. Symptoms depend on how big the hole is. 20-60% close spontaneously during first year of life. The bigger the hole the more blood volume overwhelms pulmonary system, resulting in pulmonary vascular resistance. Right side of heart may hypertrophy if not fixed.
Clinical manifestations mirror those of heart failure
Describe Patent Ductus Arteriosus
Increased pulmonary blood flow (acyanotic)
Artery that connects the aorta and pulmonary artery in utero (fetal ductus arteriosus) doesn’t close within the first few weeks of life causing left to right shunt.
Machinery-like murmur. Moderate to large PDAs may present as left-sided volume overload or pulmonary arterial hypertension
Describe Coarctation of Aorta
Obstruction to blood flow from ventricles (acyanotic)
The entrance to the aorta is small and the upper part of the descending aorta is narrowed so the upper extremities have bounding pulses whereas lower extremities have weak pulses. Is really serious in infants, often requires mechanical ventilation. Older children get dizzy and have nose bleeds.
Aortic Stenosis
Obstruction to blood flow from ventricles (acyanotic)
Aortic valve is weird looking and/or small which makes the LV hypertrophy, cardiac output less. VALVULAR AS is the worst version of aortic stenosis because it causes random episodes of MI. No exercising.
Often have increased HR, faint pulses, hypotensive, poor feeding, exercise intolerance. At risk for infective endocarditis and heart attacks.
Pulmonic Stenosis
Obstruction to blood flow from ventricles (acyanotic)
Pulmonary artery entrance is small so blood backs up in RV which cause RV hypertrophy and decreased pulmonary blood flow. PULMONARY ATRESIA is the total occlusion of the pulmonary artery. May make the RV hypoplastic. Foramen ovale may be opened back up if the pressure on the right side of the heart exceeds the left side, which would push deoxygenated blood into the LA.
Sx include mild cyanosis, HF, cardiomegaly, systemic venous engorgement
Describe Tetrology of Fallot
Decreased pulmonary blood flow (cyanotic)
Pulmonary artery is small (pulmonic stenosis), right ventricle is hypertrophied (right ventricular hypertrophy), the septum isn’t between the L/R ventricle (ventricular septal defect), the aorta is taking up both oxygenated and deoxygenated blood (overriding aorta)
Sx: “tets spells”: baby suddenly has blue lips, skin, nails after feeding, crying, or waking up
Tricuspid Atresia
Decreased pulmonary blood flow (cyanotic)
Tricuspid (r side valve) doesn’t develop so pressurized venous blood moves either through a patent foramen ovale or a atrial septal defect to the left side of the heart. The left side of the heart pumps mixed blood throughout the body. There are usually other malformed parts of the heart like transposition of the great arteries or narrowed pulmonary artery.
Sx include cyanosis, tachycardia, dyspnea clubbing
Transposition of Great Arteries
Mixed blood flow (cyanotic)
The pulmonary artery is where the aorta should be (leaving left ventricle) and the aorta is where the pulmonary artery should be (leaving the right ventricle). There is usually a patent foramen ovale or other holes in the heart.
Sx depends on if there are any holes. Holes actually help the baby be less cyanotic. If there are no holes in the septum, the baby will be severely cyanotic and cardiomegaly will be present within the first few weeks of life.
Total Anomalous Pulmonary Venous Return
Mixed blood flow (cyanotic)
Instead of the pulmonary veins sending oxygenated blood to the left atrium, it sends it back into the venous system of the heart or the right atrium. The heart has to have some sort of hole in the septum. The right side of the heart gets bigger and the left side gets smaller. The blood on both sides of the heart contain the same oxygenation level.
The patient’s level of cyanosis depends on how much blood is pumped through the pulmonary artery. The more blood pumped, the less cyanosis.
Truncus Arteriosus
Mixed blood flow (cyanotic)
The aorta and pulmonary artery are the same vessel. More blood flows through lungs and less flows systemically.
Severe HF Sx, cyanosis, poor growth, activity intolerance.
Hypoplastic Left Heart Syndrome
Mixed blood flow (cyanotic)
The left side of the heart is completely underdeveloped so blood flows passively through the patent foramen ovale back to deoxygenated right side of heart and uses the non-closed ductus arteriosus to get into the aorta and out to the body.
Milf cyanosis and HF sx until the ductus arteriosus closes then severe cyanosis and decreased CO
Right sided HF Patho/Sx
RV doesn’t pump well into pulm artery which increases pressure in RA and systemic venous circulation. Makes your spleen big and causes peripheral edema.
Left sided HF Patho/Sx
LV can’t pump well into systemic circulation so the pulmonary everything gets backed up and the lungs get congested w/ blood. Sx include cyanosis, fatigue, decreased flow to kidneys causes Na and H2O resorption causing fluid overload
