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Intro to Congenital Heart Disease Flashcards

1
Q

What are the 4 types of ASD’s?

A
  1. Ostium Secundum
  2. Ostium Primum
  3. Sinus Venosus
  4. Coronary Sinus
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2
Q

What is the most common type of ASD?

A

Secundum

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3
Q

What is ASD Secundum associatad with?

A

Mitral Valve Prolapse (MVP)

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4
Q

ASD Secundum is amenable to what therapy?

A

Closure in the cath lab

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5
Q

Where is primum ASD found near?

A

Close to AV Valves

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6
Q

ASD Primum has what leaflet disorders?

A
  1. Cleft AV Valve Leaflets
  2. Cleft Septal Tricuspid Valve Leaflets
  3. Cleft Anterior Mitral Valve Leaflets
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7
Q

ASD Primum associated with what systemic pathology?

A

Trisomy 21

Endocardial Cushion Defect

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8
Q

What are the two types of Sinus Venosus defect?
which is more common?

A

Superior Vena Cavae Sinus Venosus ASD >. Inferior Vena Cavae Sinus Venosus ASD

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9
Q

Superior Sinus Venosus ASD is associated with what syndrome?

A

Anomalous Pulmonary Venous Drainage of the right upper pulmonray vein

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10
Q

Inferior Sinus Venosus VSD is associated with what syndrome?

A

Scimitar syndrome

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11
Q

What is a coronaray sinus ASD associated with?

A

Persistent left superior vena cavae

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12
Q

Primum ASD classified as what type of AV Canal?

A

Partial AV Canal

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13
Q

Primum ASD with restrictive inlet VSD classified as what type of AV Canal?

A

Transitional AV Canal

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14
Q

Primum ASD with non-restrictive inlet VSD classified as what type of AV Canal?

A

Complete AV Canala

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15
Q

What is simetar syndrome?

A
  1. Hypoplastic RLL of the lung
  2. Aorto to Pulmonray Collateral blood flow of RLL
  3. Anomalous pulmonary venous drainage to “Simetar sword” from RLL to IVC
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16
Q

What is a coronary sinus ASD

A

Persistent Left Superior Vena Cava that drains into the Coronary Sinus

Defect is an unroofing of Coronary Sinus allowing higher pressure LA blood to drain into the CS and then drain into the low pressure RA

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17
Q

Where is aa secundum ASD located?

A

Fossa Ovalis

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18
Q

In both of these images, what is the bottom right arrow pointing to?

What is the relevance to this positioning?

A

Crista Terminalis

The crista terminalis is generally a smooth-surfaced, thick portion of heart muscle in a crescent shape at the opening into the right atrial appendage.

Secumdum ASD = Middle

Sinus Venosus ASD = Closer to Crista Terminalis

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19
Q

What type of ASD is present here?

A

Secundum ASD = Located in the Fossa Ovalis

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20
Q

What is seen here?

A

PFO

*NOTE: PFO does not equal ASD*

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21
Q

What is the difference between a PFO and an ASD?

A

Patent foramen ovale (PFO) and is flap-like valve in between left and right atria found in ~ 25 percent of adults that remains open as an intraatrial shunt

ASD = Open communication between the atria after septation (4 types as discussed)

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22
Q

What is the flap seen here?

A

Flap = Septum Primum and is what is a PFO with blood coming under the flap

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23
Q

Due to the location of primum ASD, what is a common sequalae that needs to be addressed emergently?

A

Complete heart block after repair (Due to close proximity to AV Valve (AV nodes)

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24
Q

What exactly is an endocardial cushion defect?

A

Primum ASD + Inlet VSD = Complete AV Canal

Involve AV septum and AV valves

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25
What is seen at the green arrow?
Ostium Primum
26
What is seen in the middle arrow?
Complete AV canal
27
What is seen here?
Sinus Venosus ASD
28
Sinus Venosus VSD associated with?
Anomalous Pulmonary Venous Return Sinus **Venosus** = Anomalous Pulmonary **Venous** return
29
How do you see a sinus venosus defect?
Pull back from ME 4 chamber as this is a higher defect
30
What is the size of a normal coronary sinus?
\<10 mm
31
What is seen in a coronary sinus ASD?
Dilated coronary sinus \>10 mm
32
How will you investiagate a Coronary Sinus ASD?
Left sided IV --\> Inject contrast Coronary sinus bubbles/contrast will light up first before filling RA due to persistent Left SVC
33
What are the 4 major ways of classifying VSD in terms of location?
1. Relative to Crista Supraventricularis 2. Relative to RV inflow/outflow 3. Relationship to the Semilunar Valves 4. Relationship to the septum
34
What are the two subclasses of crista supraventricular VSD?
**Infracristal** vs. **Supracristal**
35
What are the two subclasses of VSD relative to the RV inflow and outflow?
**Inlet** vs. **Outlet**
36
What are the subclasses of VSD in relationship to semilunara valves?
**Subaortic** and **Subpulmonic**
37
What are the VSD subclasses in relationship to the septum?
Malalignment Membranous vs. Muscular
38
What are the "A" types of VSD seen here?
A = Outlet (Subpulmonic)
39
What are the "B" types of VSD seen here?
B = Membranous (Subaortic)
40
What are the "C" types of VSD seen here?
C = Inlet
41
What are the "D" types of VSD seen here?
D = Muscular (Trabecular)
42
What is the most common type of VSD?
**Membranous** (Guess this on the exam)
43
What are the other names for Membranous VSD?
Para Peri Infracristal Subaortic
44
What are the other names for Conoventricular VSD?
Infracristal Subaortic
45
What are the other names for Outlet VSD?
Subpulmonic Supracristal Conal Intraconal Subarterial
46
What are the other names for Inlet VSD?
AV Canal Type
47
What are the other names for Muscular VSD?
Trabecular
48
What is an inlet VSD associated with?
Trisomy 21 Cleft AV valve leaflets
49
What type of VSD is seen with Tetrology of Fallot?
Anterior Malalignment VSD that is classified as a membranous vs. conoventricular ASD \*Ask Echo attending\*
50
What are the 4 criteria of Tetrology of Fallot?
1. VSD (Anterior Malignment) 2. Over-riding Aorta causing outflow tract obstruction 3. Right Ventricular Hypertrophy 4. Pulmonary Obstruction (Pulmonic Stenosis, Right and Main PA stenosis)
51
What type of VSD is this?
Membranous VSD
52
Outlet VSD are associated with what?
**Prolapse of the Right Coronary Cusp**
53
Outlet VSD are: Anterior or Posterior?
Anterior (Will see in ME 5 chamber) near LVOT
54
What are the synonyms for Outlet VSDs?
Subpulmonic Supracristal Conal Intraconal Subarterial Doubly Committed Type 1
55
What type of VSD is seen here?
**Outlet** aka **Subpulmonic** aka **Subarterial** aka **Conal** aka **Supracristal** VSD
56
What is are an **inlet VSD** associated with?
Cleft Anterior Mitral Valve Leaflets
57
Inlet VSD and a Primum ASD make up what?
**Complete AV Canal** (Primum ASD by itself = Partial AV Canal)
58
**Primum ASD** with Restrictive **Inlet VSD** = What?
Transitional AV Canal
59
Inlet VSD are associated with what syndrome?
Trisomy 21
60
What are the 4 synonyms for Inlet VSDs?
1. AV Canal Type ASD 2. Endocardial Cushion Defect 3. AV Septal Defect VSD 4. Type 3 VSD
61
What is seen here?
**Complete AV Canal** 1. Inlet VSD shown 2. Primum ASD shown
62
What primary change in a TOF creates the 4 anatomic/physiological phenomenon?
**Anterior and Rightward Shifted Septum** Leads to: 1. Overriding Aorta 2. VSD 3. Pulmonary Obstruction 4. RVH
63
What is seen at A?
Membranous VSD
64
What is associated with A?
LV septal Aneurysm (TV tissue plugging the hole)
65
What is Scmitar Syndrome associated with?
**Inferior Sinus Venosus Defect (ASD)** Scmitar vein that drains from the hypoplastic low lower lobe to the IVC (Vein looks like an Arabian Sword)
66
What type of VSD is associated with AV canal defect?
Inlet VSD
67
Trisomy 21 is associated with what VSD?
Inlet VSD
68
Defect in the **septum primum** results in what type of ASD?
Secundum ASD
69
What is Label B?
Primum ASD
70
What is Label C?
Inlet VSD
71
What arch abnormality is seen in 25% of TOF patients?
Right aortic arch
72
What type of VSD is seen in TOF patients?
Anterior Malalignment VSD
73
Why would a PFO not be repaired for a TOF repair?
1. PFO allows for decompression (pop-off valve for the RV) 2. Augment LV filling at expense of oxygenation
74
Why is RV failure common after TOF repair?
1. Right Ventriculotomy to address RVOT 2. Thick RV (Not protected well from cardioplegia) 3. Bubbles cascade down anterior RCA worsens RV function after bypass
75
Mitral Valve Prolapse is associated with what ASD?
Secundum ASD
76
Persistent Left SVC is associated with what ASD?
Coronary Sinus ASD
77
Trisomy 21 associated with what ASD?
Ostium primum ASD
78
Cleft Anterior Mitral valve leaflet associated with what intercardiac communication(s)? Name 2
Primum ASD Inlet VSD
79
Anomalous Pulmonaray Venous Return is associated with what ASD?
Sinus Venosus ASD
80
What is the most common ASD?
Secundum ASD
81
Where are secundum ASD located?
Fossa Ovalis
82
Secundum ASD a result from a defect in what?
Septum Primum
83

PTE me (33 decks)

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