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OB 2 > Normal and Abnormal Fetal Heart > Flashcards

Normal and Abnormal Fetal Heart Flashcards

1
Q

At how many weeks does the heart start to circulate?

A

5 weeks

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2
Q

When do structures fuse to form a single heart tube?

A

22 days

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3
Q

What structures separate the atria and ventricles and when do they begin to develop?

A

Endocardial cushions
27 days

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4
Q

What does the septum primum divide?

A

L and R atria

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5
Q

When is the aorticopulmonary septum formed?

A

7th week

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6
Q

When has the heart completed formation?

A

8th week

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7
Q

The UV shunts blood into what structure?

A

Ductus venosus –> IVC

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8
Q

Through what valve does blood pass to enter the foramen ovale –> LA

A

Eustachian valve

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9
Q

Where does blood go coming from the IVC versus coming from the SVC?

A

IVC –> eustachian valve –> foramen ovale –> LA

SVC –> TV –> RV –> PV –> ductus arteriosus –> aortic and systemic circulation

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10
Q

Where is the more highly oxygenated blood shunted to from the aorta?

A

Cranial portion

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11
Q

Blood in the LA is contributed by what structures?

A

Pulmonary veins and from RA through the foramen ovale

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12
Q

How to tell what side of the heart is which in a TRV view?

A

L side is closer to the spine

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13
Q

What is the term for the normal angle of the heart?

A

Levocardia

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14
Q

What typically oocurs to the heart within the chest when there is a mass lesion seen in the thoracic cavity?

A

Dextroposition and mesocardia

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15
Q

What is the term for the heart on the right side but apex is pointing to the left?

A

Dextroposition

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16
Q

In the fetal heart, will the RV or LV appear slightly larger?

A

RV

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17
Q

What structure should the foraminal flap open into?

A

LA

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18
Q

What structures does the ductal arch view encompass?

A

Pulmonary artery
Ductus arteriosus
Desc Ao

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19
Q

What valves can you see in SAX of the fetal heart?

A

PV
TV
Ao V

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20
Q

What structures encompass the aortic arch?

A
  1. Brachiocephalic A
  2. LCCA
  3. L subclavian A
  4. Desc Ao
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21
Q

What is the smallest vessel in the 3VV?

A

SVC

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22
Q

What is the most common benign fetal arrhythmia?

A

PAC

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23
Q

What is a non-conducted PAC?

A

Stops at the AV node

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24
Q

bpm in SVT?
Ratio of atrial to ventricular contractions?

A

180-300bpm
1:1

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25
Q

What heart rate is considered tachycardia in the fetus?

A

> 180

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26
Q

What heart rate is considered bradycardia in a fetus?

A

<100

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27
Q

A fetus that does not respond to treatment of SVT is at risk for what two things?

A

Heart failure and non-immune hydrops

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28
Q

What arrythmia is between 300-400bpm and has a 2:1 ratio of atrial to ventricular beats?

A

Atrial flutter

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29
Q

What arrythmia does not have a set atrial or ventricular contraction rate?

A

A-fib >400bpm

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30
Q

What heart abnormality has a normal atrial rate and slower ventricular rate?

A) 1st degree HB
B) 2nd degree HB
C) 3rd degree HB
D) Atrial flutter

A

3rd degree heart block

31
Q

What is the term for a bradycardic rate that comes and goes?

A

Transient Bradycardia

32
Q

What are the most common cardiac malformations?

A

VSD’s

33
Q

In what heart abnormality is it common to see VSD’s?

A

TOF

34
Q

What are the four types of VSD’s?

A
  1. Inlet - close to the TV’s- can detect in 4Ch view
  2. Outlet - most superior and close to the AoV and PV
  3. Trabecular AKA midmuscular or central
  4. Apical - Past the insertion point of the moderator band
35
Q

Most common types of ASD’s in order?

A
  1. Ostium secundum - m/c
  2. Ostium primum
  3. Sinus venosus
36
Q

Which ASD is most commonly associated with a AV defect?

A

Ostium primum as it is right next to the IVS

37
Q

In what abnormality will result in fetal death without the presence of an ASD?

A

Transposition of the great vessels

38
Q

What are AVSD’s also called?

A

AV canal or endocardial cushion defect

39
Q

What heart abnormality is associated with all trisomies?

A

AVSD’s

40
Q

What is the most common severe left sided obstructive lesion?

A

Hypoplastic L heart syndrome

41
Q

What heart defect is the most common cause of death or stillbirth?

A

Hypoplastic L heart syndrome

42
Q

What abnormality may not present until 2nd trimester?

A

hypoplastic L heart syndrome

42
Q

What findings in the 2nd trimester is suspicious of hypoplastic L heart syndrome?

A

Mitral stenosis

43
Q

What does RV hypoplasia generally result from?

A

Pulmonary atresia but can also occur due to tricuspid atresia

44
Q

What heart abnormality is seen with a ductal-dependent lesion?

A

RV hypoplasia

45
Q

What is a progressive lesion that tends to worsen as pregnancy continues?

A

Tricuspid atresia

46
Q

What are the most common sites for Aortic coarctation?

A

Ductal and postductal

47
Q

Describe types A, B, and C of aortic coarctaction?

A

A: distal to Lsubclavian artery
B: b/w L subclavian and LCCA
C: b/w LCCA and brachiocephalic trunk

48
Q

Visualization of a larger RV without any other abnormalities is suspicious of what?

A

Aortic coarctation

49
Q

What abnormality is associated with aortic coarctation?

A

Bicuspid Ao valve

50
Q

What is the most common form of cyanotic heart disease?

A

TOF

51
Q

Classic features of TOF? (4)

A
  1. Perimembranous VSD
  2. Overriding aorta
  3. Pulmonary atresia
  4. RV hypertrophy
52
Q

3 types of PA abnormalities with TOF

A
  1. Pulmonary stenosis
  2. Pulmonary atresia with patent ductus
  3. Pulmonary atresia with aortopulmonary collaterals
53
Q

What abnormality causes a larger RA and smaller RV?

A

Ebstein Anomaly due to the TV being displaced far down in the RV

54
Q

What measurement between MV and TV is likely to diagnose ebstein anomaly?

A

> 8mm

55
Q

What anomaly is associated with maternal ingestion of lithium carbonate?

A

Ebstein anomaly

56
Q

In complete transposition, where is the Ao in relation to the PA?

A

Ao is to the right

57
Q

In what TGA are the RA and RV concordant?

A

Complete transposition -
RA connects to RV which connects to Ao

LA connects to LV which connects to PA

58
Q

T or F? Complete TGA is more common than incomplete TGA

A

True

59
Q

What are the connections in the heart with incomplete TGA?

A

RA connects to LV which connects to PA

LA connects to RV which connect to Ao

60
Q

Why does truncus arteriosis occur?

A

Failure of the pulmonary and aortic trunks to fuse

61
Q

What chambers does the truncus arteriosis receive blood from?

A

LV and RV

62
Q

What is the most common type of DORV?

A

DORV with a subaortic VSD

63
Q

Where is the VSD in a VSD type DORV?

A

Below the aorta

64
Q

Where is the VSD in a TGA type DORV?

A

Below the pulmonary artery

65
Q

Where is the VSD in a Fallot type?

A

Doubly-commited meaning there is a VSD below both the PA and Ao and pulmonary stenosis

66
Q

Where is the VSD in a non-committed DORV?

A

VSD is in a remote location

67
Q

What two cardiac abnormalities will you see the Ao and PA running in parallel rather than crossing over?

A
  1. TGA
  2. DORV
68
Q

A strong association of poorly controlled diabetes has contributed to what heart abnormality?

A

DORV

69
Q

What is the most common fetal cardiac tumour?

A

Rhabdomyoma

70
Q

What arrythmia is most commonly seen with a fetal rhabdomyoma?

A

SVT

71
Q

The normal aorta should be seen crossing over the PA in which orientation?

A) Posteriorly
B) Anteriorly
C) Laterally
D) Medially

A

Anteriorly

72
Q

How do you obtain the 3VV from a 4CH?

A

Move transducer cephalad

73
Q

You see a defect near the SVC, what type of ASD is it?

A

Sinus venosus

OB 2 (20 decks)

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