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Structural Heart Defects Flashcards

1
Q

Four characteristics of tetralogy of fallot

A
  1. Ventricular Septal Defect
  2. Pulmonary Stenosis
  3. Hypertrophy of RV
  4. Overriding Aorta
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2
Q

Pathophysiology of tetralogy of ballot

A
  1. Stenosis of RV outflow leads to Rv being higher pressure than left
  2. Blue blood passes from RV to LV
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3
Q

Symptom of patients with tetralogy of ballot

A

Patients are BLUE

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4
Q

How is tetralogy of fallot repaired

A

Black-Taussig Shunt - 1944

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5
Q

When is surgical intervention of tetralogy of fallot done

A

Before the age of two years

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6
Q

Side-effect of tetralogy of fallot surgery

A

Pulmonary valve regurgitation in adults life - redo surgery

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7
Q

What is seen in an ECG in tetralogy of ballot

A
  1. WRS duration - 142 msec
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8
Q

Symptoms of tetralogy of Fallot

A

None

Echo every pulmonary regurgitation

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9
Q

What is ventricular dental defect

A

Abnormal connection between two ventricles

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10
Q

How common are VSDs

A

20% of all congenital heart defects

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11
Q

Pathophysiology of VSDs

A
  1. High pressure LV
  2. Low pressure RV
  3. Blood flows from high pressure chamber to low pressure chamber
  4. Increased blood flow through the lungs
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12
Q

What is the large VSD physiology

A

1, Breathless, poor feeding, failure to thrive

2. Require fixing in infancy

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13
Q

What can large VSD lead to

A

Eisenmengers Syndrome

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14
Q

Surgical procedure to fix VSD

A

PA band, complete repair

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15
Q

Does minor VSD need intervention

A

No, it’s asymptomatic

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16
Q

Clinical signs of large VSD

A
  1. Small breathless skinny baby
  2. Increased respiratory rate
  3. tachycardia
  4. Big heart on CXR
  5. Murmur varies in intensity
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17
Q

Clinical signs of small VSD

A
  1. Loud systolic murmur
  2. Thrill (buzzing sensation)
  3. Well Grown
  4. Normal HR
  5. Normal Heart Size
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18
Q

What is Eisenmengers Syndrome

A
  1. High pressure pulmonary blood flow
  2. Damages pulmonary vasculature
  3. Reisstance to blood flow through lungs increase
  4. Rv pressure increases
  5. Shunt direction reverses

PATIENT IS BLUE

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19
Q

What is an atrial septal defect

A

Abnormal connection between the two atria

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20
Q

How common are atrial septal defects

A

Common

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21
Q

When do ASDs present

A

Adulthood

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22
Q

ASD pathophysiology

A

Slightly higher pressure in the LA than the RA

Shunt is left to right

Therefore not BLUE patient

Increased flow into right heart + lungs

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23
Q

Large ASD physiology

A
  1. Significant increased flow through the night heart and lungs in childhood
  2. Right Heart dilation
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24
Q

Signs of Large ASD

A

Chest infections

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25
Intervention for ASD
Right heart should be closed
26
Is right heart dilation seen in small ASD
No
27
Intervention for minor ASD
None, leave alone
28
What happens to the shunt in small ASDs as age increases
Shunt increases in gradient size
29
ASD clinical signs
1. Pulmonary flow murmur 2. Fixed split second heart sound (delayed closure of PV because more blood has to get out) 3. Big pulmonary arteries on CXR 4. Big heart on CXR
30
What inheritable condition are Atrio-ventricular septal defects seen with
Downs Syndrome
31
What is AVSD
Hole in the very centre of the heart
32
What structures does AVSD involved
Ventricular and atrial septum, mitral and tricuspid valves
33
What happens to the AV valves in AVSD
Instead of two skepearet valves, there is one big malformed one, causing greater leaks
34
Physiology of complete AVSD
1. Breathlessness as neonate 2. Poor weight gain 3. Poor feeding 4. Torrential pulmonary blood flow 5. Needs repair or PA band in infancy 6. Repaire is surgically challenging
35
Physiology of partial AVSD
1. Can present in late adulthood 2. Presents like a small VSD/ASD 3. May be left alone if there is no right heart dilation
36
What is patent ductus arterioles
Ductus arterioles does not close
37
Symptoms of patent ductus arterioles
Big heart, breathlessness Continuous murmur
38
What can patent ductus arterioles lead to
Eisenmenger's syndrome
39
How is Eisenmenger's syndrome caused by patent ductus arterioles different from other caused eisenmenger's syndrome
Cyanosis of toes not fingers (fingers remain pink)
40
Physiology of patent ductus arteriosus
1. Torrential flow from aorta to pulmonary arteries in infancy 2. Breathlessness 3. Poor feeding 4. Failure to thrive
41
Intervention for PDA
Surgically closed
42
In what babies is PDA more of a concern
Premature
43
What condition can patent ductus arterioles increase the risk of
Endocarditis
44
How is PDA surgically closed
1. Venous approach
45
What is coarctation of aorta
1. Narrowing of aorta at the site of inception of ductus arteriosus
46
Consequence of sever coarctation
1. Complete obstruction to aortic flow
47
What can happen to the to the aorta heart failure and coarctation
Collapse
48
What does mild coarctation of the aorta present with
1. Hypertension | 2. Mild murmur
49
Should mild coarctation of the aorta be repaired
Yes
50
Clinical signs of coarctation
1. Right Arm hypertension 2. Buzzes (bruits) over scapular and back from collateral vessels 3. Murmur
51
What are long-term problems of coarctation
1. Hypertension (early strokes, CAD, sub-arachnoid haemorrhages) 2. Re-coarctation requiring repeat intervention 3. Aneurysm at site of repair
52
Surgical vs percutaneous repair
1. Surgical - subclavian flap repair | 2. End-to-end repair
53
How many cusps does normal AV have
Three
54
How common are bicuspid AV valves
Common (more in males)
55
Effect of Bicuspid AVs on function
Stenotic in infancy or childhood
56
Properties of bicuspid valves vs normal valved
1. Degenerate faster 2. Become regurgitant earlier 3. Associated with coarctation and dilatation of ascending aorta
57
What is pulmonary stenosis
1. Narrowing of the outflow of RV
58
Three types of causes for pulmonary stenosis
1. Valvular 2. Sub-valvular 3. Supra-valvular
59
Consequences of severe pulmonary stenosis
1. RV failure as a neonate 2. Collapse 3. Poor pulmonary blood flow 3. RV hypertrophy 5. Tricuspid regurgitation
60
Moderate pulmonary stenosis consequences
1. Well-tolerated for many years | 2. RV hypertrophy
61
How is pulmonary stenosis treated
1. Balloon valvuloplasty 2. Open valvotomy 3. Open trans-annular patch 4. Shunt (bypass blockage)

Year 2 (155 decks)

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