Session 3-Congenital Heart Disease

Question 1

What is the O2 saturation in the RA?

Answer 1

67%

Question 2

What is the O2 saturation in the RV?

Answer 2

67%

Question 3

What is the O2 saturation in the LA?

Answer 3

99%

Question 4

What is the O2 saturation in the LV?

Answer 4

99%

Question 5

What is the O2 saturation in the pulmonary artery?

Answer 5

67%

Question 6

What is the O2 saturation in the aorta?

Answer 6

99%

Question 7

What is the pressure in the RA?

Answer 7

/4

Question 8

What is the pressure in the RV?

Answer 8

25/3

Question 9

What is the pressure in the pulmonary artery?

Answer 9

25/10

Question 10

What is the pressure in the LA?

Answer 10

/5

Question 11

What is the pressure in the LV?

Answer 11

80/4

Question 12

What is the pressure in the aorta?

Answer 12

80/40

Question 13

What is the O2 saturation in the venous system?

Answer 13

~60-70%

Question 14

True or false: increased lung blood flow is damaging

Answer 14

FALSE - not damaging but increased pulmonary artery or pulmonary venous pressure is

Question 15

What are the two classifications of congenital heart disease?

Answer 15

Acyanotic

Cyanotic

Question 16

What are the haemodynamic effects of atrial septal defects? (4)

Answer 16

1) increased pulmonary blood flow
2) RV volume overload
3) pulmonary hypertension (rare)
4) eventual right heart failure

Question 17

What are the haemodynamic effects of ventricular septal defects? (4)

Answer 17

1) left to right shunt
2) LV volume overload
3) pulmonary venous congestion
4) eventual pulmonary hypertension

Question 18

In which condition are atrio-ventricular septal defects common?

Answer 18

Down syndrome

Question 19

What is coarctation?

Answer 19

Congenital narrowing of short section of aorta

Question 20

What is tetralogy of Fallot?

Answer 20

During development, RV and LV separate and the arteries rotate round each other but in this condition, they don’t rotate enough and ventricular septum doesn’t close

Question 21

What are the effects of tetralogy of Fallot? (4)

Answer 21

1) pulmonary stenosis
2) ventricular septal defect
3) RV hypertrophy
4) over-riding aorta

Question 22

What is the patho-physiology of tricuspid atresia? (3)

Answer 22

1) no RV inlet
2) R to L atrial shunt of entire venous return
3) blood flow to lungs via ventricular septal defect (or patent ductus arteriosus)

Question 23

What happens in hypoplastic left heart? (4)

Answer 23

1) LV is underdeveloped
2) ascending aorta is very small
3) RV supports systemic circulation
4) obligatory R to L shunt

Question 24

What happens when there is transposition of the great arteries? (3)

Answer 24

1) right vent connected to aorta
2) left vent connected to pulmonary artery
3) not viable unless two circuits communicate ie via atrial, ventricular or ductal shunts

Question 25

True or false: transposition of great arteries is an example of bi-directional shunting

Answer 25

TRUE

Question 26

What is the patho-physiology of pulmonary atresia? (3)

Answer 26

1) no RV outlet
2) R to L atrial shunt of entire venous return
3) blood flow to lungs via patent ductus arteriosus (PDA)

Question 27

True or false: atrial septal defects (ASD) are usually asymptomatic late into adulthood

Answer 27

TRUE

Question 28

What can untreated ventricular septal defects (VSD) lead to?

Answer 28

In-operable pulmonary hypertension

Question 29

True or false: transposition/hypoplastic left heart/pre-ductal coarctation/pulmonary atresia are often due to increased pulmonary blood flow

Answer 29

FALSE - reduced pulmonary blood flow