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Year 2 > Structural Heart Defects > Flashcards

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
Q

Intervention for ASD

A

Right heart should be closed

26
Q

Is right heart dilation seen in small ASD

A

No

27
Q

Intervention for minor ASD

A

None, leave alone

28
Q

What happens to the shunt in small ASDs as age increases

A

Shunt increases in gradient size

29
Q

ASD clinical signs

A
  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
Q

What inheritable condition are Atrio-ventricular septal defects seen with

A

Downs Syndrome

31
Q

What is AVSD

A

Hole in the very centre of the heart

32
Q

What structures does AVSD involved

A

Ventricular and atrial septum, mitral and tricuspid valves

33
Q

What happens to the AV valves in AVSD

A

Instead of two skepearet valves, there is one big malformed one, causing greater leaks

34
Q

Physiology of complete AVSD

A
  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
Q

Physiology of partial AVSD

A
  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
Q

What is patent ductus arterioles

A

Ductus arterioles does not close

37
Q

Symptoms of patent ductus arterioles

A

Big heart, breathlessness

Continuous murmur

38
Q

What can patent ductus arterioles lead to

A

Eisenmenger’s syndrome

39
Q

How is Eisenmenger’s syndrome caused by patent ductus arterioles different from other caused eisenmenger’s syndrome

A

Cyanosis of toes not fingers (fingers remain pink)

40
Q

Physiology of patent ductus arteriosus

A
  1. Torrential flow from aorta to pulmonary arteries in infancy
  2. Breathlessness
  3. Poor feeding
  4. Failure to thrive
41
Q

Intervention for PDA

A

Surgically closed

42
Q

In what babies is PDA more of a concern

A

Premature

43
Q

What condition can patent ductus arterioles increase the risk of

A

Endocarditis

44
Q

How is PDA surgically closed

A
  1. Venous approach
45
Q

What is coarctation of aorta

A
  1. Narrowing of aorta at the site of inception of ductus arteriosus
46
Q

Consequence of sever coarctation

A
  1. Complete obstruction to aortic flow
47
Q

What can happen to the to the aorta heart failure and coarctation

A

Collapse

48
Q

What does mild coarctation of the aorta present with

A
  1. Hypertension

2. Mild murmur

49
Q

Should mild coarctation of the aorta be repaired

A

Yes

50
Q

Clinical signs of coarctation

A
  1. Right Arm hypertension
  2. Buzzes (bruits) over scapular and back from collateral vessels
  3. Murmur
51
Q

What are long-term problems of coarctation

A
  1. Hypertension (early strokes, CAD, sub-arachnoid haemorrhages)
  2. Re-coarctation requiring repeat intervention
  3. Aneurysm at site of repair
52
Q

Surgical vs percutaneous repair

A
  1. Surgical - subclavian flap repair

2. End-to-end repair

53
Q

How many cusps does normal AV have

A

Three

54
Q

How common are bicuspid AV valves

A

Common (more in males)

55
Q

Effect of Bicuspid AVs on function

A

Stenotic in infancy or childhood

56
Q

Properties of bicuspid valves vs normal valved

A
  1. Degenerate faster
  2. Become regurgitant earlier
  3. Associated with coarctation and dilatation of ascending aorta
57
Q

What is pulmonary stenosis

A
  1. Narrowing of the outflow of RV
58
Q

Three types of causes for pulmonary stenosis

A
  1. Valvular
  2. Sub-valvular
  3. Supra-valvular
59
Q

Consequences of severe pulmonary stenosis

A
  1. RV failure as a neonate
  2. Collapse
  3. Poor pulmonary blood flow
  4. RV hypertrophy
  5. Tricuspid regurgitation
60
Q

Moderate pulmonary stenosis consequences

A
  1. Well-tolerated for many years

2. RV hypertrophy

61
Q

How is pulmonary stenosis treated

A
  1. Balloon valvuloplasty
  2. Open valvotomy
  3. Open trans-annular patch
  4. Shunt (bypass blockage)

Year 2 (155 decks)

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