Pathology Flashcards
What type of CHD can result from Rubella infection?
VSD, PDA, and Tetraology of Fallot
Which chromosomal abnormalities can lead to CHD?
Trisomy 21 Downs, 18 Edwards, 13 Patau, XO Turner
Name an obstructive congenital heart abnormality?
Coarchtation of the aorta
What a R to L shunt is characterized by what features?
Name a few CHD that shunt this direction
cyanosis
clubbing of fingers
polycythemia (increasing RBC)
paradoxical embolism- septal defects allow emboli to travel to the brain.
Tetrology of Fallot
Transposition of the great vessels
L to R shunts result in what type of heart problems and complications?
Pulmonary HTN, RVH and reversal of shunt leading to a late cyanosis.
i.e VSD
The Tetrology of Fallot does what to the gross anatomy of the heart?
Large Boot shaped heart (like you got kicked with a boot) Pulmonary stenosis RVH Overriding aorta VSD
Whats the main determanent for a mild or severe Tetrology of Fallot and why?
Pulmonary stenosis because a mild pulmonary stenosis will present much like a VSD
A severe pulmonary stenosis will result in RVH and shunt switching from R to L with accompanying cyanosis
You will not see increased pulmonary HTN because the stenosed pulmonary valve is protective of the low pressure in the lungs.
What will happen to the R and L ventricles in a Transposition of the great vessels? Which kids are most susceptible?
RVH-R ven now pumps to systemic circulation
LVA-L ven atrophy b/c it now pumps to the pulmonary circulation.
Those with Diabetic mothers
Will Transpostion of the G.V lead to death?
Depends on if shunting is present
No shunt=death Stable shunt (VSD) ok Unstable shunt (PFO, PDA) worrysome
Your patient is a 8 month old with a VSD, what should you do?
A) wait for it to close on its own
B) Perform heart surgery to close the septum
C) Wait for RVH to show signs of cyanosis
D) Use NSAIDs to fix the defect
Wait for it to close on its own. 50% will do so spontaneously (no drugs; that’s a PDA). If its a small VSD you might not worry about it even if it doesn’t close. If its large and they’re a year old surgery should be done. These larger VSD can cause shunt reversals, surgery before cyanosis.
How might you detect a shunt reversal in a patient with PDA?
lower extremity cyanosis b/c the ductus arteriosis is inferior to the subclavian vein, so the deoxygenated blood bypass the upper extremity.
An endocardial cushion defect would lead to which specific CHD?
A) VSD B) ASD C) ASD secundum D) ASD primum E) Tetrology of Fallot
D- ASD primum: This occurs when the septum primum does not fuse with the endocardial cushion.
The foramen ovale is closed
Represents 10% ASD
Describe the various ways in which you can develop a ASD secundum
A short septum primum or secundum will result in an enlarged foramen ovale (not a PFO). This defective septal defect makes up 90% of ASD.
