Pathophysiology of Congenital Heart Disease Flashcards
What is specific to congenital heart disease as opposed to broader heart disease?
You are born with it - resulting from incorrect embryological development
Name two syndromes resulting from chromosome abnormalities that are associated with congenital heart disease (CHD for the purpose of these flashcards).
Downs
Turners
What is a branchial arch?
Primitive arches giving rise to blood vessels post-natallly
What does the 4th arch give rise to?
Right: Right Subclavian Artery
Left: Arch of Aorta
What is the most common failure leading to CHD?
Septation
How is the fossa ovalis kept open?
Pressure from r. atrium is strong so blasts through premium and secundum
What does failure of septation lead to
VSD & ASD
Failure of development leads to…?
Obstruction - atresia, stanosis or coarctation (narrowing) (of aorta)
Hypoplasia
What is dextracardia?
Heart is on the wrong side
What does failure of or incorrect rotation lead to?
TGA & congenitally corrected transposition of great vessels; dextrocardia
What does ‘failure of closure’ refer to?
Ductus arteriosus
What can be the result of pulmonary flow being greater than systemic flow (Qp>Qs)? (shunt ratio)
Heart failure
Reactive pulmonary hypertension
What is the definition of cyanosis?
Greater than 5g of haemoglobin per decilitre of blood being deoxygenated
What is the definition of pulmonary hypertension?
> 30mmHg systolic pressure (resulting from increased Qp)
What two things can keep the foetal circulation going during surgery?
Prostaglandins
Rashkind
What is polycythaemia?
Abnormally increased haemoglobin in the blood, most likely through overexertion of erythropoietin so increased RBC production and large hematocrit population
What is pulmonary hypertension and what is it caused by?
High flow through pulmonary bed caused by genetic influences
Where can differential cyanosis (pink top, blue bottom) be observed? Give more details about this ‘complex’.
Eisenmenger’s Complex
Left to right shunt reverses to become right to left shunt causing cyanosis
- murmur disappears
What is the difference between ostium secundum ASD and ostium premium ASD?
Where the hole is: in secundum it is generally in isolation; in primum it is generally in association with other defects or factors
Generally speaking, is there a murmur present in ASD?
No
Generally speaking, is there a murmur present in VSD?
Yes
What does aortic coarctation cause?
Systemic hypertension
In which gender is aortic coarctation more common?
Males
What is the treatment of aortic coarctation?
Balloon dilatation (or surgery)
What does the Tetralogy of Fallot cause?
Cyanotic Heart Disease
What does the Tetralogy of Fallot cause?
Cyanosis
