Pediatric Cardiology & Congenital Heart Disease - Quiz 5 Flashcards
What are the most common Congenital Heart Defects?
Bicuspid Aortic Valve
Ventricular Septal Defect (VSD)
Atrial Septal Defect (Secundum)
Cyanotic Lesions
TOF
What are some Environmental Factors that contribute to Congenital Heart Defects?
Chronic Maternal Disease
Maternal Meds, Drug, & ETOH Abuse
What is Retinoic Acid?
Found in cosmetics to treat skin problems, but has teratogenic properties, so preggos should avoid
What is the result of the Recirculation of Pulmonary Venous Blood?
L –> R Shunt
What results with the Recirculation of Systemic Venous Blood?
R –> L Shunt
What happens w/ Single-Ventricular Physiology?
Ventricle pumps out Mix of Pulm. & Systemic Blood
Distribution depends on Intra/Extracardiac Resistance in 2 parallel circuits
O2 Sat is the same in both Aorta & Pulm. Artery
Life is not compatible w/ Parallel Blood Flow Circuits w/ Transposition of the Great Vessels (TGA). How is this problem solved?
Intercirculatory Mixing provided by communication via a ASD, VSD, PFO, or PDA.
In regards to Intercirculatory Mixing, what determines the Arterial Saturation?
Volumes & Sats of Recirculated Systemic & Effective Systemic Venous Blood reaching the Aorta
What is Fontan Physiology?
When Systemic Venous Blood passively flows directly into the Pulmonary Circulation, then returns to a common atrium and single venticle.
Which heart conditions cause Cyanotic Heart Disease w/ Decreased Pulmonary Flow?
TOF
Tricuspid Atresia
Univentricular Heart w/ Pulm. Stenosis
Which heart conditions cause Cyanotic Heart Disease w/ Increased Pulmonary Flow?
Transposition of Great Arteries (TGA)
&
Total Anomalous Pulmonary Venous Return
Which heart conditions cause Acyanotic Heart Disease d/t a L–>R Shunt Lesion?
VSD
ASD
AVSD
PDA
Which heart conditions cause Acyanotic Heart Disease d/t an Obstructive Lesion?
Aortic Stenosis
Pulm. Valve Stenosis
Coarctation of Aorta
What are the One-Ventricle Lesion heart conditions?
Hypoplastic Left Heart Syndrome
Tricuspid Atresia
Double Inlet LV
Unbalance AVSD
What are the Two-Ventricle heart conditions?
Truncus Arteriosus
TOF w/ Pulm. Atresia
Severe Neonatal Aortic Stenosis
What are the LV Obstructive Lesion heart conditions?
Mitral Stenosis
Aortic Stenosis
Coarctation
Mixing of Systemic & Pulm. Venous Blood
What is the PO2 & O2 Sat in the Placenta?
PO2: 32-35 mmHg
O2 Sat: 80%
In Fetal Circulation, what is the PO2 & O2 Sat when the blood in the IVC joins the SVC Drainage?
PO2: 12-14 mmHg
O2 Sat: 40%
In Fetal Circulation what is the PO2 & O2 Sat of the blood traveling from the Ascending Aorta to the Brain, Coronary Arteries & Upper Limbs?
PO2: 20-22 mmHg
O2 Sat: 65%
What is the PO2 & O2 Sat for the Blood in the Descending Aorta in regards to Fetal Circulation?
PO2: 20-22 mmHg
O2 Sat: 55%
Why is the P50 Lower in Fetal Hgb?
To help w/ O2 Uptake in the Placenta
With Fetal Circulation, How does the RV compare to the LV?
Same Size & Thickness
RV has Higher Output @ 1.3 : 1
Pumps 450 mL/kg/min
What causes the Foramen Ovale to close?
When LA pressure is more than RA Pressure causing the FO’s Flap Valve to close against the Septum Secundum
Functional Closure of the Ductus Arteriosus happens in 10-72 hrs after birth. What else happens at this time?
↑Arterial O2 Tension
↓Prostaglandins
Lung Expansion releases Bradykinin
What happens to Cardiac Output after Birth?
Increases 30-80%
What is the Main Purpose of Transitional Circulation?
Separate Systemic & Pulm Circulation
Close FO & DA (Reversible for a few days)
What can cause the FO to Reopen?
Crying & Pain
Hypoxia
Hypercarbia
Acidosis
Lung Disease
Sepsis
How long does it take for the Anatomic Closure of the FO?
3 months & 1 year when the Septum Primum & Secundum adhese
How long does it take for the Anatomic Closure of the DA?
1 - 3 months when the Ligamentum Arteriosum forms
What can cause the Ductus Arteriosus to Reopen?
Decrease in O2 Tension
What is Alprostadil used for?
Prostalglandin E1 - used to open the DA
(and also to treat ED)
What are signs of a PDA?
Hyperactive Precordium
Bounding Pulse
Wide Pulse Pressure
Hepatomegaly
Tachypnea
Tachycardia
What med can be given to close a PDA?
Indomethacin - prostaglandin inhibitor
What is the Blood Volume of a Premi?
100 mL/kg
What is the Blood Volume for a < 3 month old?
90 mL/kg
What is the Blood Volume for a baby older than 12 months?
Same as Adult 70 mL/kg
What is the Blood Volume for a 3-12 month old baby?
80 mL/kg
With Fetal & Newborn hearts, how is Cardiac Output increased?
By Increasing HR b/c increasing preload has little effect