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CVS > Lecture 8 > Flashcards

Lecture 8 Flashcards

1
Q

What are some causes of congenital heart disease?

A
  • Genetic (Down’s, Turner’s, Marfan’s syndrome:more likely to have a CHD)
  • environmental (teratogenic drugs, alcohol)
  • maternal infections (rubella, toxoplasmosis)
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2
Q

Does the pulmonary circulation have high/low resistance?

A

Low

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3
Q

What maintains the pumping of the heart?

A
  • Pressure gradient

- Muscle pumping

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4
Q

What are the units for pressure?

A

mmHg (equivalent to cm)

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5
Q

What does relaxation of the right ventricle cause?

A

Cause a suction like motion helping the blood drain into it.

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6
Q

Pressure/pO2 reading in each chamber of the heart:

A

RA: 4mmHg, 67% pO2
RV: 3mmHg diastole/25 mmHg systole, 67% pO2
PT: 10mmHg diastole/25mmHg systole, 67% pO2
LA: 5 mmHg, 100% pO2
LV: 4mmHg diastole/80mmHg child/120mmHg adult systole
A: 40mmHg diastole/80mmHg systole

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7
Q

What is the effect of a L to R shunt?

A
  • blood from left heart is returned to lungs instead of going to the body
  • increased lung blood flow (not damaging alone), but increased pulmonary artery/venous pressure is
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8
Q

What is the effect of a R to L shunt?

A

De-oxygenated blood bypasses the lungs

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9
Q

What are the 2 classifications of CHD’s?

A

Acyanotic (don’t alter oxygen levels)

Cyanotic (systemic oxygen levels are lower)

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10
Q

What are some acyanotic CHD’s?

A
  • L to R shunts

- obstructive lesions (aortic/pulmonary stenosis, mitral stenosis, coarctation of the aorta)

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11
Q

What is coarctation of the aorta?

A

Narrowing of the aorta (congenital), usually in area where the ductus arteriosus inserts.
-cyanotic

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12
Q

What are some cyanotic CHD’s?

A

Complex R to L shunts

  • tetralogy of fallot
  • transposition of great arteries
  • univentricular heart
  • total anomalous pulmonary venous drainage
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13
Q

What is total anomalous pulmonary venous drainage?

A

All 4 pulmonary veins don’t connect normally to LA

-instead they drain oxygenated blood into the superior vena cava so oxygen rich blood isn’t going to the body

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14
Q

What do atrial septal defects cause?

hole b/w the atria

A

L-R shunt

  • increased pulmonary flow (pressure not increased)
  • RV volume overload
  • eventual right heart failure
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15
Q

What do ventricular septal defects cause?

A

L-R shunt

  • pulmonary venous congestion (extra blood into lungs)
  • eventual pulmonary hypertension
  • LV volume overload (due to increase in BP in RV, therefore increased pulmonary flow= LV overload)
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16
Q

What is an atrio-ventricular septal defect?

A

Can’t separate the side of the heart.

17
Q

What is aortic stenosis?

A

Narrowing of aortic valve opening, restricting blood flow, could lead to increase in pressure of left ventricle/atrium

18
Q

What causes lots of defects in the tetralogy of fallot?

A

Over-rotation causes aorta to be further right

19
Q

What is tricuspid atresia and its effects?

A

Tricuspid heart valve is missing/ under developed.

  • no RV inlet
  • R-L atrial shunt of entire venous return
  • blood flow to lungs via ventricular septal defect or patent ductus arteriosus (blood high pressure in aorta so oxygenated blood would move back to pulmonary arteries)
20
Q

What does transposition of the great arteries cause?

A
  • causes the systemic & pulmonary circulation to become separate
  • requires a bi-directional shunt
21
Q

How do you correct transposition of the great arteries when a baby is born?

A

They become cyanotic very quickly

  • give them drugs to open shunts
  • then do operation
22
Q

What does a hypoplastic left heart cause?

A
  • left ventricle underdeveloped
  • ascending aorta is very small
  • RV supports systemic circulation via obligatory atrial septal defect and PDA (right to left ductal shunt)
23
Q

How could you deconstrict the aorta?

A

Inject prostaglandins

24
Q

What is pulmonary atresia ?

A
  • pulmonary valve does not form properly
  • requires R-L shunt for entire venous return
  • blood flow to lungs via patent ductus arteriosus
25
Q

When does atrial septal defect show symtoms?

A

Asymptomatic until late into adulthood

-late onset arrythmia & right heart failure

26
Q

When does ventral septal defect present with symptoms?

A

Unless small, in infancy with left heart failure.

untreated can lead to inpoerable pulmonary hypertension

CVS (16 decks)

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