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CNIH > Fetal Heart Anomalies PT 1 > Flashcards

Fetal Heart Anomalies PT 1 Flashcards

1
Q

umbilical vein job?

A

Returns 80% saturated blood from the placenta to the fetus

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2
Q

Umbilical arteries function?

A

carry mainly deoxygenated blood back to the placenta for oxygenation

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3
Q

at what week does erythropoeisis take place?

A

week 3

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4
Q

Ductus venosus function?

- what does it become at birth?

A
  • oxygenated blood from the umbilical vein isshunted away from the livervia the ductus venosus to the IVC
  • becomes ligamentum venosum upon closure at birth
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5
Q

Foramen ovale function?

- what does it become?

A
  • oxygenated blood entering the right atrium isdiverted from the lungsthrough the foramen ovale into the left atrium to deliver oxygenated blood to the body
  • closes after birth and becomes fossa ovalis
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6
Q

Ductus arteriosusfunction?

- what does it become?

A
  • connects pulmonary artery to aortic arch
  • deoxygenated blood that enters the right ventricle to be pumped through the pulmonary arteries is mostly diverted from the lungs to the body into the aortic arch via the ductus arteriosus
  • becomesligamentum arteriosumupon closure at birth
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7
Q

Dextrocardia?

A
  • Heart is located in the right side of the chest with apex pointing to the right
  • reciprocal of levocardia
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8
Q

Dextroposition

- mortality rate?

A
  • heart is located in the right side of chest but the apex pointing to the left
  • 81% mortality
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9
Q

Mesocardia?

A

heart is located in the middle portion of the chest with the apex pointing along the midline

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10
Q

the heart occupies how much of thoracic area?

A

1/3rd

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11
Q

Regular cardiac rate and rhythm?

A

120-160 or 180bpm

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12
Q

What is concidered the most posterior atria?

A
  • Left atrium
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13
Q

where is the left atrium located?

- relation to aorta?

A
  • most posterior atria

- located immediately anterior to the descending aorta

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14
Q

What can be seen in the left atrium? (3)

A
  • foramen ovale flap
  • pulmonary veins
  • atrial septum primum
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15
Q

What is typically larger the right or left ventricle?

A

Right

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16
Q

Where is the moderator band located?

A

right ventricular apex

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17
Q

Where is te mitral valve loacted?

A

between the morphologic LA and LV

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18
Q

Where is the tricuspid valve located?

A

between the morphologic RA and RV

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19
Q

What is seen in the 3 VV?

A
  • 3 vessels: pulmonary artery, aorta, SVC

- trachea

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20
Q

What does the 3 VV enable the diagnosis of? (6)

A

coarctation of the aorta
right aortic arch
double aortic arch (seen in tetralogy of fallot)
Absence of a great artery
Truncus arteriosus
Transposisition of the great arteries (TGA)

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21
Q

What 4 things are associated with tetralogy of Fallot?

A
  • ventricular septal defect
  • thickened muscle wall
  • pulmonary valve stenosis
  • misplaced aorta
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22
Q

What is TGA? (transposition of the great arteries)

A
  • Aorta rises from the right ventricle
  • PA rises from the left ventricle
  • 4-7% of all heart defects
  • Simple transposition can be successfully treated with arterial switch operation within the first week of life
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23
Q

Truncus arteriosis?

  • % of heart anomalies?
  • almost always associated with?
A
  • Single trunk supplies both the pulmonary and systemic circulation
  • 2% of congenital heart abnormalites
  • Almost always associated with a VSD
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24
Q

Truncus arteriosis prognosis?

A
  • Due to parallel fetal circulation, truncus arteriosus does not cause any hemodynamic problem in utero
  • Major problem postnatally and, if left untreated, approximately 80% of infants die within the first year
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25
Q

Why must fetal lie be determined?

A
  • so the left and ride structures can be assessed

- to diagnose complex cardicac malformations accreately

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26
Q

Scanning plane while evaluating abdominal situs?

A
  • level of the intrahepatic portion of the umbilical vein
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27
Q

Normal situs of fetus?

A
  • aorta lies to the left

- IVc lies to the right of the spine

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28
Q

LVOT?

A

The aorta arises first, sweeping to the fetal right

29
Q

RVOT?

A
  • The pulmonary artery crosses over

- Early bifurcation into the right and left branch pulmonary arteries, characteristic of the pulmonary arter

30
Q

The three vessel and trachea view

A
  • Enables a comparison of the transverse aortic arch and ductal arch
  • They should be of similar sizes.
31
Q

What is the leading cause of infant mortality?

A

Congenital heart disease

32
Q

Common indications for fetal echo?

A
  • hydrops
  • Polyhydramnios
  • Fetal arrhythmia
  • Chromosomal anomalies
  • Family history
  • Maternal disease (diabetes)
33
Q

What is a sinoatrial node?

- where is it located?

A
  • The normal regularrhythmof the heart is set by the natural pacemaker of the heart called the sinoatrial (orsinus) node
  • located in the wall of the right atrium
34
Q

What is the normal fetal heart rate in the 2nd and 3rd trimesters?

A

120-160 bpm

35
Q

Irregular rhythm?

- relatively common during?

A

Irregular rhythm is the most common arrhythmia and relatively common during the 3rd trimester

36
Q

What are most irregular rhythms due to?

A

premature atriam contractions (PAC’s)

37
Q

What is an arrhythmia?

A
  • Irregular rhythm

- Premature atrial or ventricular contractions

38
Q

What is a complete heart block?

A

\complete dissociation between the atria and ventricles.

39
Q

Fetal bradycardia?

A
  • abnormally low heart rate (<100 bpm)
40
Q

What is commonly seen in bradycardia?

A
  • atrioventricular block
41
Q

What does M-mose help demonstrate?

A

discrepancy in atrial and ventricular rates

42
Q

of all arrhythmias what one has the most likelihood to be associated with a structural heart abnormality?

A

bradycardia

43
Q

what is the most frequently associated structural defect?

A

artioventricular canal defect

44
Q

Tachycardia?

A
  • heart rate >180 bpm
45
Q

risk factors associated with tachycardia? (2)

A

risk of:

  • congestive heart failure
  • hydrops
46
Q

What is mild tachycardia?

A
  • > 160bpm can occur as a normal variant during fetal movement
47
Q

Normal fetal heart position?

A
  • bulk of heart located in the left anterior quadrant of chest
  • cardiac axis 45 degree angle to the midline
48
Q

Normal range of cardiac axis?

A

22-75 degrees

49
Q

levocardia?

A
  • normal cardiac position and axis
50
Q

actopia cordis?

A
  • rare

- heart is located outside the thoracic cavity

51
Q

what is actopia cordia a result from?

A
  • failure of fusion of the lateral body fold in the thoracic region
52
Q

4 classifications of ectopia cords?

A
  1. thoracic (60%)
  2. abdominal (30%)
  3. thoracic abdominal (7%)
  4. cervical (3%)
53
Q

thoracic ectopia cordis?

A

heart displaced from the thoracic cavity through a sternal defect

54
Q

abdominal ectopia cordis?

A

heart displaced into the abdomen through a diaphragmatic defect

55
Q

thoracic abdominal ectopia cordis?

A

The heart is displaced from the chest through a defect in the lower sternum, with an associated diaphragmatic or ventral abdominal wall defect

56
Q

what is pentalogy of cantrell?

A
  • syndrome that causes defects involving thediaphragm,abdominal wall,pericardium,heartand lowersternum
  • diagnosis made as early as 10 weeks GA
  • prognosis poor
57
Q

Cervical actopia cordis?

A

heart displaced in the neck area

58
Q

atrial septal defects (ASD) results from?

A

an error in the amount of tissue reabsorbed or deposited in the interatrial septum

59
Q

Ventricular Septal Defect (VSD)?

  • seen as?
  • associated with?
A
  • seen as holes in the ventricular septum

Associated with:

  • chromosomal abnormality
  • diabetes
60
Q

what is te most common cardiac anomaly?

A

Ventricular Septal Defect (VSD)

61
Q

of the structural cardiac defects Ventricular Septal Defect’s have the highest?

A
  • recurrence rate

- hightest association with teratogen exposure

62
Q

What measurment is concidered a small VSD?

A

<2mm

63
Q

Atrioventricular Septal Defect (AVSD) AKA?

A

endocardical cushion defect

64
Q

What is Atrioventricular Septal Defect (AVSD) identified as?

A
  • defect in the lower position of the atrial septum and upper portion of the ventricular septum
65
Q

What is Atrioventricular Septal Defect (AVSD) most commonly associated with?

A
  • Tri- 21 (30-40%)

- Complete heart block may be present due to interruption of the conduction tissue

66
Q

AVSDs 3 categories?

A
  1. complete
  2. incomplete
  3. transitional
67
Q

Complete AVSD?

A

There are defects in all structures formed by the endocardial cushions: defects (holes) in the atrial and ventricular septa, and the AV valve remains undivided or “common.”

68
Q

Partial or incomplete AVSD

A
  • Part of the ventricular septum formed by the endocardial cushions has filled in and the tricuspid and mitral valves are divided into two distinct valves

CNIH (69 decks)

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