Session 3- Congenital Heart Disease

Question 1

what are acyanotic congenital HD

Answer 1

left to right shunts
obstructive lesions
pulmonary stenosis

Question 2

cyanotic congenital HD

Answer 2

complex, right to left shunt

Question 3

what does a left to right shunt do

Answer 3

• blood from the left heart is retuned to the lungs instead of going to the body
• increased lung blood flow by itself is not damaging, but increased pulmonary artery or pulmonary venous pressure is

Question 4

what does right to left shunt do

Answer 4

requires a hole and distal obstruction

deoxygenated blood bypasses lungs

Question 5

atrial septal defects

Answer 5

opening of septum between the two atria which persists after birth

because left atrial pressure is normally high than right atrial pressure, flow will mainly be from left to right

Question 6

ventricular septal defects

Answer 6

abnormal opening in the interventricular septum 
blood flow from left to right 
LV volume overload 
pulmonary venous congestion
eventual pulmonary hypertension 

ACYANOTIC

Question 7

what is patent ductus arteriosus

Answer 7

failure to close ductus arteriosus
blood flow through a PDA will be from aorta to pulmonary artery after birth

ACYANOTIC

Question 8

coacrtation of aorta

Answer 8

narrowing of aortic lumen in the region of the ligamentum arteriosum- former ductus arteriosus

narrowing increases afterload on the left vebtricle and can lead to left ventricular hypertrophy

ACYANOTIC

Question 9

Tetralogy of Fallot

Answer 9

group of 4 lesions occuring together as the result of single developmental defect which places the outflow portion of the interventricular septum too far in the anterior and cephaloid directions

4 anomalies

• Ventricular septal defect
• overriding aorta
• pulmonary stenosis
• hypertrophy of right ventricle

CYANOTIC

Question 10

Tricuspid atresia

Answer 10

leaves no inlet to the right ventricle
there must be a complete right to left shunt of all the blood returning to the RA and a ventricular septal defect or patent ductus arteriosus to allow blood flow to lungs

CYANOTIC

Question 11

transposition of great arteries

Answer 11

results in 2 unconnected parallel circulations instead of 2 circulations in series. In this defect the right ventricle is connected to the aorta and the left ventricle to the pulmonary trunk

can lead to hypoplastic left heart

Question 12

describe the closure of the foramen ovale after birth

Answer 12

As the newborn takes his/her 1st breath → the lungs expand
● This decreases the pulmonary pressure → also decreases the pressure in the pulmonary circulation
● Resulting in RA & RV pressure decreasing
● As LA/LV pressure > than RA/RV, this reverses the flow of blood
● The foramen ovale (flaps) are pushed against and eventually fuses with the septum secundum
● Leading to the formation of the fossa ovalis (remnant of the foramen ovale).