Heart IV Flashcards
Most frequent heart defect in Trisomy 21 (Down’s Syndrome)
Atrioventricular Septal Defect (AVSD)
Atrioventricular Septal Defect (AVSD) is composed of two types of septal defect which are …
Primum type ASD and membranous type VSD
Atrioventricular Septal Defect is a ……
Severe endocardial cushion defect where there is an large defect in the atrioventricular wall.
Murmurs, failure to thrive, Cyanosis, and Pulmonary Hypertension are clinical presentations of …..
Coronary Heart Disease
The following are characteristics of which type of shunt:
• Venous blood from the right heart (pulmonary circuit) is mixed with the arterial blood in the left heart.
• There is decreased pulmonary blood flow which results in cyanosis (Early Cyanosis)
• The primary cause is an ASD or VSD associated with high pressure on the right side of the heart.
Right to Left Shunts
The following are characteristics of which type of shunt:
• Excess volume through the right heart and pulmonary circuit causes pulmonary hypertension
• If untreated the workload of the right ventricle is increased lead to RVH and heart failure
• If pulmonary vascular pressures rise enough lead to pulmonary edema and cyanosis (Late Cyanosis)
Left to Right Shunts
The following diseases are characteristic of which type of shunt:
– VSD – ASD – PDA
Left to Right Shunts
The following diseases are characteristic of which type of shunt:
– Truncus arteriosus
– Transposition of the great vessels
– Tricuspid atresia
– Total anomalous pulmonary venous return
Right to Left Shunts
Congenital heart disease associated with faulty migration of ……….. cells
Neural Crest Cells
Faulty migration of neural crests results in….. and cause these main defects ……
Abnormal partitioning of the Truncus Arteriosus
• Main defects are:
- Tetralogy of Fallot
- Transposition of great vessels
- Persistent truncus (mild cyanosis)
- Aorticopulmonary septal defects
Anterior superior displacement of the bulbar (infundibular) septum
Pulmonary Stenosis
Pulmonary Stenosis results in ……
Results in unequal division of the truncus arteriosus into a small (stenotic) pulmonary trunk and a large aorta riding over the interventricular septum
Misalignment of the truncal ridges, bulbar ridges and endocardial cushions results in failed fusion of these membranous septum components
Ventricular Septal Defect (VSD)
Tetralogy of Fallot is an example of a ……. shunt that results in ………….. and ……….
- Right to Left Shunt
- Right ventricular hypertrophy – due to increased workload resulting from pulmonary stenosis
- Overriding aorta – aorta “rides over” the interventricular septum (there is a membranous VSD as described in 1. above), receiving blood pumped from both ventricles
Symptoms of Tetralogy of Fallot are….
Cyanosis occuring with vigorous crying, feeding or agitation
Switching of aorta and pulmonary trunk that is immediately lethal unless combined with another defect – PDA, ASD, VSD
Transposition of the Great Vessels
Transposition of the Great Vessels is caused by …….
Faulty migration of neural crest cells leads to the absence of the spiral-twist in the aortico-pulmonary septum
Failure of complete separation of the aorta and pulmonary artery caused by Failure of neural crest cells migration leads to failure in formation of aortico-pulmonary septum
Persistent Truncus Arteriosus
- Must be accompanied with a VSD or immediate death
Persistent Truncus Arteriosus is associated with which diseases?
DiGeorge’s syndrome
Abnormal drainage of the pulmonary veins into the systemic venous circulation resulting in severe cyanosis immediately after birth.
Total Anomalous Pulmonary Venous Return (TAPVR)
- Must be accompanied with a ASD or PDA to be compatible with life
Disease: Pericardium and heart are exposed through a defect in the chest wall
– Failure of lateral walls to fuse in Week 4
Ectopia Cordis
Disease: Inflammation of pericardium caused by • Infectious • Renal failure • Post myocardial infarction • Post-surgical etc.
Pericarditis
Pericarditis results in ……… a sound due to roughness of the parietal lining from inflammatory process.
Pericardial Friction Rub
The accumulation of excess fluid within the pericardial space from results in arteries
Pericardial Effusion
– Causes:
• Pericarditis
• Connective tissue diseases
• Hypothyroidism
Rapid Large fluid (usually blood) accumulation in the pericardial space leading to compression which prevents adequate filling of the chambers
Pericardial Tamponade
Clinical Signs of Pericardial Tamponade:
Beck’s Triad:
• Hypotension-decreased ventricular filling
• Distant heart sounds-fluid in pericardial cavity
• Distended neck veins-decreased diastole filling
Pericardial Tamponade Causes:
Potential causes:
Stab wound
Myocardial infarction
Rupture of heart muscle
Pericardial Tamponade Treatment:
Pericardiocentesis:
• Paraxiphoid approach – tip of the xiphoid, or between xiphoid and left costal margin, angled towards left shoulder.
• Apical approach - left 5th or 6th intercostal space
………. vein connects basilic and cephalic at cubital fossa
Median Cubital Vein
Anterior penetrating wounds would more likely penetrate which part of the heart?
Right Ventricle
Enlargement of the Left Ventricle can cause dysphagia because of its ….. position of the esophagus.
Anterior
