Pediatric cardio

Question 1

what are the two small openings between the left and right sides of the heart

Answer 1

Ductus arteriosus(DA), Foramen ovale. (FO)

Question 2

Foramen oval (FO) function

Answer 2

Blood then passes through FO to the left atrium and then to the left ventricle and out the aorta.

Question 3

Where does most oxygenated blood in the fetus go?

Answer 3

Most oxygenated blood goes to brain

Question 4

Fetal hemoglobin (HgbF) has greater or smaller affinity for oxygen than maternal blood

Answer 4

greater. Hemoglobin concentration of fetus is high

Question 5

Congenital Defects in infants

Answer 5

Occurring at birth or failure of normal development of cardiovascular system
Usually abnormal opening between adjacent heart chambers

Question 6

Congenital Defects in infants causes

Answer 6

Viral infection, hereditary, Down Syndrome, Teratogens

Question 7

APGAR Score

Answer 7

The 1-minute score determines how well the baby tolerated the birthing process. The 5-minute score tells the doctor how well the baby is doing outside the mother’s womb. Normal is 7 or above. A score of 10 is unusual

Question 8

Shunting

Answer 8

Left to Right (acyanotic)

Right to left shunt (cyanotic)

Question 9

Left to Right (acyanotic)

Answer 9

Arterial Septal Defect (ASD)
Patent Ductus Arteriosum (PDA)
Ventricular Septal Defect (VSD)

Question 10

Right to left shunt (cyanotic)

Answer 10

Transposition of great vessels
Tricuspid atresia
Tetralogy of Fallot
Total anomalous pulmonary venous return

Question 11

Patent Ductus Arteriosus (PDA)

Answer 11

when the DA doesn’t close
PDA creates Left to right shunt
(Aorta to Pulmonary Artery)
Creates high pressure in pulm. art.

Question 12

Patent Ductus Arteriosus (PDA) might lead to

Answer 12

Increased ventricular work

Possible heart failure

Pneumonia

Question 13

Atrial Septal Defects (ASD)

Answer 13

Blood flow between the atria

Forms a left to right shunt

Question 14

Atrial Septal Defects (ASD) might lead to

Answer 14

May result in R heart failure

Question 15

Ventral Septal Defects (VSD)

Answer 15

It involves a hole in the wall between the heart’s lower chambers.
Most common congenital heart defect is ventral septal defect (VSD)
Forms left to right shunt

Question 16

Eisenmenger’s syndrome

cyanotic problem

Answer 16

If pressures in right ventricle become too high, blood can shunt right to left

Question 17

Ventral Septal Defects (VSD) might lead to

Answer 17

Large defects can result in increased pressure in pulm artery,

Question 18

Coarctation of the Aorta

Answer 18

Usually distal to subclavian artery
May be due to abnormal involution of Ductus Arteriosus
Severity dependent on degree of pinching and location
Present in 15-20% of CHD cases
Kidneys see low BP and release substances to increase BP

Question 19

Triscuspid Atresia

Answer 19

Triscuspid valve fails to develop
Limited blood flow from RA to RV, Underdeveloped RV
Right to left shunt
Surgery Required

Question 20

Pulmonary Valve Atresia

Answer 20

Pulmonary valve fails to develop
No exit from the right ventricle
Blood regurgitates into the left atrium via the foramen ovale
The lungs get perfused retrograde flow via a wide PDA

Question 21

Tetralogy of Fallot

Answer 21

Tetralogy of Fallot is made up of four defects:
VSD
Pulmonary Valve Stenosis
Overriding Aorta (usually lies over VSD)
RV Hypertophy (due to PV Stenosis)
Blueness appears soon after birth, in infancy or childhood

Question 22

Transposition of the Great Vessels

Answer 22

Positions of Pulmonary Artery and aorta reversed
Deoxygenated blood from RV goes into systemic circuit
O2 from blood goes back into lung

Question 23

Hypoplastic Left Heart Syndrome (HLHS)

Answer 23

Failure or inadequate development of the left ventricle.
Variable aortic & mitral involvement

Child is dependent upon a PDA for systemic perfusion.

Without intervention, HLHS is fatal within the first weeks of life

Question 24

Total Anomalous Pulmonary Venous Return (TAPVR)

Answer 24

Pulmonary veins don’t connect to the left atrium.
Supracardiac, Cardiac or Infracardiac
Child will require surgery soon after birth, considered a critical congenital heart defect.

Question 25

Supracardiac (TAPVR)

Answer 25

In this type of TAPVR, a mixture of oxygen-poor and oxygen-rich blood returns to the right atrium through the superior vena cava.

Question 26

Cardiac (TAPVR)

Answer 26

TAPVR, the pulmonary veins meet behind the heart and connect to the right atrium. The coronary sinus connects the pulmonary veins to the right atrium in this type of TAPVR.

Question 27

Infracardiac (TAPVR)

Answer 27

A mixture of oxygen-poor blood and oxygen-rich blood returns to the right atrium from the veins of the liver and the inferior vena cava,

Question 28

Extracorporeal Membrane Oxygenation (ECMO)

Answer 28

Support cardiac and respiratory systems until disease process resolves
ECMO is used for longer-term support ranging from 3-10 days

Question 29

Norwood Procedure

Answer 29

Surgeons create a “new” aorta and connect it to the right ventricle
The heart then becomes a “single ventricle” structure capable of pumping mixed blood to lungs and periphery.
Arterial oxygen saturation following procedure 70-75%

Question 30

Bi-directional Glenn Shunt Procedure

Answer 30

Creates a direct connection between the pulmonary artery and thesuperior vena cava.
Directly returns venous blood to lungs, from UE.

Question 31

Fontan Procedure

Answer 31

Doctors now connect the pulmonary artery to theinferior vena cava.
Now venous blood completely bypasses the right ventricle
Once this procedure is complete, oxygen-rich and oxygen-poor blood no longer mix in the heart and the infant’s skin will be cyanotic.