mod13 part II

Question 1

Cyanotic Congenital heart lesions:

Answer 1

tetralogy of fallot
transposition of the great arteries
Ebstein’s Anomaly
Eisenmenger’s syndrome

Question 2

Tetralogy of Fallot

Answer 2

most common form of cyanotic CHD; results from single developmental defect causing a combo of four anomalies

Question 3

4 anomalies of tetralogy of fallot

Answer 3

large overriding aorta
malalignment ventricular septal defect
pulmonary stenosis
right ventricular hypertrophy

Question 4

Formation of Tetralogy of Fallot

Answer 4

occurs when there is anterior and cephalad displacement of the interventricular outflow tract

Question 5

signs/symptoms of tetralogy of fallot

Answer 5

degree of cyanosis is related to degree of pulmonary stenosis; infants show clubbing due to R-L shunt causing decrease O2 level in circulating blood

Question 6

diagnosis of tetralogy of fallot

Answer 6

echo used to visualize the 4 anomalies and quantify size of VSD and severity of stenosis

Question 7

Treatment of tetralogy of fallot

Answer 7

blalock-taussig shunt
waterston
potts
closure of VSD

Question 8

Transposition of the great vessels (aka dextro-TGA)

Answer 8

occurs when great vessel (Aorta/pulmonary artery) originates from OPPOSITE ventricle (ie. pulmonary artery is anterior to aorta and originates from left ventricle…)

Question 9

Signs and symptoms of TGA

Answer 9

cyanosis severity depends on degree of blood being shunted from parallel circuits; condition worsens rapidly when ductus arteriosus closes

Question 10

Diagnosis of TGA

Answer 10

echo is best; visualize abnormal orientation of pulmonary artery and aorta

Question 11

Treatment of TGA

Answer 11

maintenance of PDA with prostoglandins infusion 
rashkind procedure to create ASD
Jatene procedure (atrial switch)

Question 12

Ebstein’s Anomaly

Answer 12

congenital malformation where some or all of tricuspid valve leaflets are displaced lower in the ventricle; causes large RA and small RV; portion of RV is composed of atrial tissue (dysplasia)

Question 13

signs/symptoms of ebstein’s

Answer 13

dyspnea, palpitation, intermittent cyanosis and right HF

Question 14

Diagnosis of Ebstein’s

Answer 14

tricuspid regurgitation murmur or diastolic rumble; echocardiography visualizes displaced valve; assess severity of tricuspid regurgitation

Question 15

Treatment of Ebstein’s

Answer 15

closure of ASD if present
Tricuspid valve repair/replacement
Fontan Procedure

Question 16

Eisenmenger’s syndrome

Answer 16

occurs with reversal of congenital shunt from L-R to R-L due to irreversibly elevated pulmonary vascular resistance and severe pulmonary hypertension

Question 17

signs/symptoms of Eisenmenger’s

Answer 17

hypoxia (area of inadequate blood supply) results in exertional dyspnea, cyanosis, angina, and fatigue

Question 18

Diagnosis of Eisenmenger’s

Answer 18

colour flow doppler used in echo to assess the reversal shunting of blood flow

Question 19

treatment of Eisenmenger’s

Answer 19

lung or heart-lung transplant