Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

CVS * > S4 Congenital Heart Defects > Flashcards

S4 Congenital Heart Defects Flashcards

1
Q

What are the 3 general causes of congenital heart defects?

A
  1. Genetic e.g. Down’s, Turner’s and Marfan’s syndromes
  2. Environmental e.g. drugs, alcohol, etc (malformation of embryo)
  3. Maternal infections e.g. rubella
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the normal oxygen saturation in each part of heart in a child (so slightly lower than in adults)?

A
  • R atrium - 67%
  • R ventricle - 67%
  • pulmonary trunk - 67%
  • L atrium - 99%
  • L ventricle - 99%
  • aorta - 99%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the normal pressure in each part of heart in a child (so slightly lower than in adults) in mmHg?

A
  • R atrium - /4
  • R ventricle - 25/3
  • pulmonary trunk - 25/10
  • L atrium - /5
  • L ventricle - 80/4
  • aorta - 80/40

Where the nominator is systole and the denominator is diastole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What congenital heart defects are acyanotic?

A
  • ASD, VSD an PDA (left to right shunts)
  • aortic stenosis (hypoplasia), pulmonary stenosis (valve/outflow/branch), coarction of the aorta, mitral stenosis (obstructive lesions)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What congenital heart defects are cyanotic?

A
  • tetralogy of fallot
  • transposition of the great arteries
  • total anomalous pulmonary venous drainage
  • univentricular heart

Right to left shunts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Where are the 4 places you can get shunts?

A
  1. Between atria
  2. Between ventricles
  3. Atrioventricular
  4. Aorto-pulmonary (ductal)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the haemodynamics effects of a left to right shunt?

A

It requires a hole.

Blood from the left heart is returned to the lungs instead of going to the body.

Increased lung blood flow isn’t damaging but increased pulmonary artery/pulmonary venous pressure is damaging.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the haemodynamics effects of a right to left shunt?

A

Requires a hole and a distal obstruction.

Deoxygenated blood bypasses the lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the haemodynamic effects of an atrial septal defect (ASD)?

A
  • increased pulmonary blood flow
  • right ventricle volume overload
  • pulmonary hypertension (rare)
  • eventual right heart failure

No mixing of deoxygenated and oxygenated blood pumped around the systemic circulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the haemodynamic effects of an ventricular septal defect (VSD)?

A
  • left to right shunt
  • left ventricle volume overload
  • pulmonary venous congestion
  • eventual pulmonary hypertension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which congenital heart defect is most common in those with Down’s syndrome?

A

Atrioventricular septal defects (35-40% those with Down’s syndrome that have a congenital heart defect have this one)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is coarctation?

A

Narrowing of the aorta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the haemodynamic effects of coarction of the aorta?

A

Narrowing of aortic lumen in ligamentum arteriosum region (used to be ductus arteriosus)

  • increases after load on the left ventricle
  • left ventricular hypertrophy
  • vessels to head and upper limbs aren’t compromised
  • vessels to rest of body, blood flow is reduced

The extent of symptoms depends on the severity of the coarction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is a patent foramen ovale (PFO)?

A

Present in around 20% of the population and are generally clinically silent as the higher left atrial pressure causes functional closure of the flap valve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is patent ductus arteriosus (PDA)?

A

Failure to close the ductus arteriosus

Blood flows from aorta to pulmonary artery after birth (high to low pressure) - left to right

Doesn’t cause cyanosis but can cause problems later on if untreated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is tetralogy of Fallot? What are the four anomalies?

A

4 lesions occurring together to result in a single developmental defect (outflow portion of interventricular septum too far in the anterior and cephalad directions)

Right to left shunting occurs (deoxygenated blood into systemic circulation)

  1. VSD
  2. Overriding aorta
  3. Pulmonary stenosis
  4. Right ventricular hypertrophy
17
Q

What is tricuspid atresia?

A

Lack of development of the tricuspid valve

So no inlet to the right ventricle

Results in complete right to left shunt of all blood returning to the right atrium (via a ASD or PFO) and then a VSD or PDA is needed to allow blood flow to the lungs

These can be made after birth to allow blood flow in the right direction (surgery)

18
Q

What is transposition of the great arteries?

A

Results in two unconnected parallel circulations instead of two circulations in series.

The right ventricle is connected to the aorta and the left ventricle to the pulmonary trunk

Need surgery to put in a shunt between the left and right sides e.g atrial shunt

19
Q

What is hypoplastic left heart?

A

When the left ventricle is underdeveloped resulting also in a small ascending aorta

To help, the right ventricle supports systemic circulation

There has to be a right to left shunt (need a ASD and PDA)

20
Q

What is a univentricular heart?

A

Only one ventricle (VSD)

Can be present with or without transposition of the great arteries

21
Q

What is a pulmonary atresia?

A

When there is no right ventricle outlet

So a right to left atrial shunt of the whole venous return is needed

Blood flows to the lungs via a PDA

22
Q

Which congenital heart defects are present in infancy/early childhood?

A

VSD, coarction, tetralogy of fallot

Results in left heart failure in infancy, if untreated can lead to an in-operable pulmonary hypertension (VSD)

Associated with PDA and right to left shunt in neonates (coarctation)

Cyanotic spells in infancy and early childhood (tetralogy of fallot)

23
Q

Which congenital heart defects are result as a neonatal emergency?

A

Transposition, hypoplastic left heart, pre-ductal coarctation and pulmonary atresia

Due to reduced pulmonary blood flow

24
Q

Which congenital heart defect is usually asymptomatic until late in adulthood?

A

ASD which results in late onset arrhythmia and right heart failure

Coarctation in adults results in complicated renal hypertension, left ventricle hypertrophy associated with aortic valve stenosis

Some mild cases of tetralogy of fallot are compatible with adulthood

CVS * (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions