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Echo 3 > Module 4 : Cyanotic CHD's > Flashcards

Module 4 : Cyanotic CHD's Flashcards

1
Q

what is cyanosis

A
  • blue, gray, dark purple discolouration of the mucous membranes caused by low blood oxygen
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2
Q

what causes cyanosis

A
  • oxygenated blood mixing with unoxygenated blood

- either from blood not getting to the lungs or blood not getting to the body

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3
Q

what are the signs and symptoms of a cyanotic CHD

A
  • cyanosis of lips, toes, fingers, tip of nose
  • blueish skin
  • hyperventilation
  • rounded clubbed fingers
  • delayed growth
  • tachycardia
  • sweating
  • SOB
  • chronic respiratory infections
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4
Q

how many CHDs are considered cyanotic

A
  • 8
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5
Q

what are the 5 T’s + These (three)

A
  • complete TRANSPOSITION of great arteries
  • TETROLOGY of fallot
  • TRUNCUS arteriosus
  • TOTAL anomalous pulmonary venous return
  • TRICUSPID atresia
  • pulmonary atresia
  • hypoeplastic left heart syndrome
  • double outlet right ventricle
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6
Q

what is CTGA (D transposition)

A
  • aorta arises from the morphologic RV

- pulmonary artery arises from the morphologic LV

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7
Q

what is the incidence in male to female in CTGA

A
  • 3:1 male to female
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8
Q

what are the 3 anomalies with CTGA and is it considered fatal

A
  • PFO
  • transposed PA and AO
  • PDA
  • fatal if not corrected
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9
Q

why is the otters name for complete TGA D-TGA and why is it dangerous

A
  • DEXTRO TGA
  • atrioventricular concordance with ventriculoarterial discordance
  • left and right heart are parallel
  • blood unable to travel from right to left heart
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10
Q

what is the embryology with D-TGA

A
  • instead of truncus arteriosus spiralling during development they run parallel inside truncus arteriosus
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11
Q

what vessels are connected to what ventricles and

A
  • anterior aortic valve connects to the right ventricle

- posterior pulmonic valve connects to the left ventricle

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12
Q

what is the blood flow direction in DTGA

A
  • shunt dependant lesion

- lesion pumps deoxygenated blood to he aorta and the body and oxygenated blood to the lungs

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13
Q

why is DTGA considered a shunt dependant lesion

A
  • without a shunt of any kind there is no mixing of blood as the blood goes around and in series
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14
Q

what is hypoplastic right ventricle

A
  • secondary to pulmonary atresia with no VSD

- small RV and small or absent pulmonary artery

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15
Q

why’s is hypoplastic right ventricle a shunt dependant lesion

A
  • with small or absent PV/PA and very small RV flow to the lungs is greatly affected
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16
Q

what are the common sonographic features of HLHS

A
  • small LV
  • aortic stenosis or atresia
  • mitral valve atresia
  • associated with hypoplstic aortic arch
  • associated with coarctation of the aorta
  • ASD
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17
Q

what is the what causes HLHS

A
  • underdevelopment of the left aorta complex

-

18
Q

what is the difference between HLHS and coarctation of the AO

A
  • larger portion of the aorta is blocked and this condition is more serious
19
Q

where is retrograde/biphasic flow seen with HLHS

A
  • due to low aorta pressure relative to PA pressure

- Aortic Arch, ascending aorta, coronary arteries

20
Q

what are the symptoms of HLHS

A
  • born with cyanosis
  • less severe clinical presentation if PDA is present
  • If PDA closes sudden shock appears
21
Q

what is tetralogy of Fallot

A
  • complex set of CHDs

- involves 4 anomalies fo heart

22
Q

what is the most common cyanotic CHD

A
  • tetralogy of fallot
23
Q

what are the 2 types of tetralogy of fallot

A
  • cyanotic and acyanotic
24
Q

what are the sonographic features of tetralogy of fallot

A
  • large VSD
  • overriding AO
  • pulmonary stenosis or atresia anywhere along the FVOT
  • hypertrophy of right ventricle
25
Q

what are the hemodynamics of tetralogy of fallot

A
  • tighter subpulmonary and PV stenosis the more blood shunts across the IVS into the aorta as it takes the path of lest resistance
  • overloads the systemic circulation with low oxygenated blood
  • if TOF occurs with pulmonary atresia very severe
26
Q

what is truncus arteriosus

A
  • single large vessel arising form the base of the heart
  • supplies coronary, pulmonary and systemic circulation
  • large VSD large common AO
27
Q

how many cusps with the common valve have with truncus arteriosus

A
  • 1-6 cusps
28
Q

what three vessels arise from the single trucks arteriosus trunk

A
  • coronary arteries
  • main pulmonary artery
  • aortic arch
29
Q

what is total anomalous pulmonary venous return TAPVR

A
  • pulmonary veins have no connection to the left atrium rather they drain directly of indirectly into the right atrium
30
Q

what associated anomaly needs to be present for TAPVR be survivable

A
  • ASD or PFO

-

31
Q

what are the sonographic features of TAPVR

A
  • dilated RA/RV
  • small LA
  • may have supra cardiac or infracardiac PV connection
32
Q

what are the treatments of TAPVR

A
  • atrial septostomy
    + short term (puncture the IAS to allow blood mixing)
  • anastomosis of common pulmonary vein to the LA
  • then ASD closure
33
Q

what is the definition of valvular atresia

A
  • congenital abscess or closure of a normal body opening or tubular structure
34
Q

what valves are commonly affected by valvular atresia

A
  • pulmonary or tricuspid
35
Q

what is the circulation of blood with valvular atresia

A
  • blood either makes its wy to the LV can either go out the aorta or cross the VSD to the RV and out the narrowed PV and PA
36
Q

what is tricuspid atresia

A
  • absence of direct communication between the right atrium and right ventricle
  • floor of the RA is entirely muscular with complete separation from the hypoplastic RV
  • flow crosses the ASD and back across the VSD to the RV then out the PA
37
Q

what are the 4 associated condition with tricuspid atresia

A
  • VSD
  • RV small or hypoplastic
  • +/- transposition of great arteries
  • ASD/PFO/VSD/PDA necessary for survival
38
Q

what are the 2 types of pulmonary atresia

A
  • pulmonary atresia with intact inter ventricular septum

- pulmonary atresia with ventricular septal defect

39
Q

what is pulmonary atresia with intact IVS

A
  • complete obstruction to RV outflow
  • intact inter ventricular septum only survivable if ASD/PDA present
  • hypoplasia of the tricuspid calc and right ventricle
40
Q

what are the structures are secondarily affected by pulmonary atresia with intact IVS

A
  • TV
  • RV
  • RVOT
  • branch PA
  • coronary arteries

Echo 3 (4 decks)

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