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Tga Flashcards

1
Q

What is Transposition of the Great Arteries (TGA)?

A

A congenital heart defect where the aorta arises from the right ventricle and the pulmonary artery from the left ventricle.

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2
Q

What are the two isolated circulations in TGA?

A

Systemic and pulmonary circulations, which are separate and incompatible with life without communication.

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3
Q

Why is communication between circulations necessary in TGA?

A

To allow mixing of oxygenated and deoxygenated blood for survival.

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4
Q

What is the clinical presentation of TGA at birth?

A

Central cyanosis, which is deep and seen in the tongue, lips, and limbs.

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5
Q

What is the role of the ductus arteriosus in TGA?

A

It provides a temporary communication between the systemic and pulmonary circulations.

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6
Q

What are the symptoms of TGA in infants?

A

Cyanosis, dyspnea, feeding difficulties, and failure to thrive.

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7
Q

What is the significance of cardiomegaly in TGA?

A

It indicates an enlarged heart due to increased workload.

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8
Q

What is the ‘Egg on side’ appearance on chest X-ray in TGA?

A

A characteristic heart shape seen in TGA due to the abnormal position of the great vessels.

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9
Q

What is the role of echocardiography in diagnosing TGA?

A

It confirms the abnormal connection of the great vessels and assesses heart function.

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10
Q

What is the treatment for TGA in newborns?

A

Prostaglandin infusion to keep the ductus arteriosus open and urgent surgical correction.

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11
Q

What is the pathophysiology of cyanosis in TGA?

A

Oxygenated blood circulates only in the lungs, and deoxygenated blood circulates in the body, leading to systemic desaturation.

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12
Q

What is the role of an atrial septostomy in TGA?

A

It creates a communication between the atria to allow mixing of blood.

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13
Q

What is the significance of the ‘Boot-shaped’ heart on chest X-ray?

A

It is seen in Tetralogy of Fallot, not TGA, and indicates right ventricular hypertrophy.

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14
Q

What is the role of the Rashkind procedure in TGA?

A

It is a balloon atrial septostomy to create a communication between the atria.

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15
Q

What is the arterial switch operation in TGA?

A

A surgical procedure to correct TGA by switching the aorta and pulmonary artery to their correct positions.

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16
Q

What are the complications of untreated TGA?

A

Heart failure, recurrent chest infections, and brain abscess due to chronic hypoxia.

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17
Q

What is the significance of polycythemia in TGA?

A

It is a response to chronic hypoxia, increasing the risk of thrombosis.

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18
Q

What is the role of cardiac catheterization in TGA?

A

It can be used for diagnosis and treatment, such as performing an atrial septostomy.

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19
Q

What is the significance of a narrow cardiac waist on chest X-ray in TGA?

A

It is due to the abnormal position of the great vessels.

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20
Q

What is the role of prostaglandins in TGA?

A

They keep the ductus arteriosus open, allowing temporary mixing of blood.

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21
Q

What is the embryological cause of TGA?

A

Failure of the aorticopulmonary septum to spiral during development.

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22
Q

What is the significance of the ‘Egg on string’ appearance on chest X-ray in TGA?

A

It is due to the abnormal position of the great vessels and the narrow mediastinum.

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23
Q

What is the role of the left ventricle in TGA before and after the arterial switch operation?

A

Before surgery, the left ventricle pumps blood to the lungs; after surgery, it pumps blood to the body.

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24
Q

What is the significance of the ‘Mustard’ or ‘Senning’ procedure in TGA?

A

They are atrial switch procedures that redirect blood flow but are less commonly used now.

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25
Q

What is the role of the coronary arteries in the arterial switch operation?

A

They must be reimplanted into the new aorta to ensure proper blood supply to the heart.

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26
Q

What is the significance of pulmonary congestion in TGA?

A

It indicates increased blood flow to the lungs, often due to a large VSD.

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27
Q

What is the role of the right ventricle in TGA before and after the arterial switch operation?

A

Before surgery, the right ventricle pumps blood to the body; after surgery, it pumps blood to the lungs.

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28
Q

What is the significance of the ‘Jatene procedure’ in TGA?

A

It is another name for the arterial switch operation.

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29
Q

What is the role of the foramen ovale in TGA?

A

It provides a temporary communication between the atria, allowing some mixing of blood.

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30
Q

What is the significance of the ‘Blalock-Taussig shunt’ in TGA?

A

It is a palliative procedure to increase pulmonary blood flow in cyanotic heart defects.

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31
Q

What is cyanotic heart disease?

A

Congenital heart defects that cause low oxygen levels in the blood, leading to cyanosis.

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32
Q

What are the common cyanotic heart diseases?

A

Tetralogy of Fallot, Transposition of the Great Arteries, and Tricuspid Atresia.

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33
Q

What is the clinical presentation of cyanotic heart disease?

A

Cyanosis, clubbing, and failure to thrive.

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34
Q

What is the significance of clubbing in cyanotic heart disease?

A

It is a sign of chronic hypoxia.

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35
Q

What is the role of echocardiography in cyanotic heart disease?

A

It helps diagnose the specific defect and assess heart function.

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36
Q

What is the significance of polycythemia in cyanotic heart disease?

A

It is a response to chronic hypoxia, increasing the risk of thrombosis.

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37
Q

What is the role of oxygen therapy in cyanotic heart disease?

A

It can temporarily improve oxygen levels but does not correct the underlying defect.

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38
Q

What is the significance of squatting in Tetralogy of Fallot?

A

It increases systemic vascular resistance, reducing right-to-left shunting and improving oxygenation.

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39
Q

What is the role of the Blalock-Taussig shunt in cyanotic heart disease?

A

It increases pulmonary blood flow in defects like Tetralogy of Fallot.

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40
Q

What is the significance of the ‘Boot-shaped’ heart on chest X-ray?

A

It is seen in Tetralogy of Fallot due to right ventricular hypertrophy.

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41
Q

What is the pathophysiology of cyanosis in Tetralogy of Fallot?

A

Right-to-left shunting through the VSD leads to systemic desaturation.

42
Q

What is the role of the VSD in Tetralogy of Fallot?

A

It allows right-to-left shunting, leading to cyanosis.

43
Q

What is the significance of pulmonary stenosis in Tetralogy of Fallot?

A

It restricts blood flow to the lungs, increasing right-to-left shunting.

44
Q

What is the role of the right ventricle in Tetralogy of Fallot?

A

It hypertrophies to overcome pulmonary stenosis.

45
Q

What is the significance of the ‘Tet spell’ in Tetralogy of Fallot?

A

It is a sudden episode of cyanosis and breathlessness due to increased right-to-left shunting.

46
Q

What is the role of beta-blockers in Tetralogy of Fallot?

A

They reduce the frequency of ‘Tet spells’ by decreasing right ventricular outflow obstruction.

47
Q

What is the significance of the ‘Waterston shunt’ in cyanotic heart disease?

A

It is a palliative procedure to increase pulmonary blood flow.

48
Q

What is the role of the ‘Potts shunt’ in cyanotic heart disease?

A

It connects the descending aorta to the pulmonary artery, increasing pulmonary blood flow.

49
Q

What is the significance of the ‘Glenn shunt’ in cyanotic heart disease?

A

It directs blood from the superior vena cava to the pulmonary artery, improving oxygenation.

50
Q

What is the role of the ‘Fontan procedure’ in cyanotic heart disease?

A

It directs blood from the inferior vena cava to the pulmonary artery, completing the separation of circulations.

51
Q

What is the embryological cause of Tetralogy of Fallot?

A

Anterior deviation of the infundibular septum during development.

52
Q

What is the significance of the ‘Eisenmenger syndrome’ in cyanotic heart disease?

A

It is a complication where left-to-right shunting reverses due to pulmonary hypertension.

53
Q

What is the role of the ‘Rastelli procedure’ in cyanotic heart disease?

A

It is a surgical correction for defects like TGA with VSD and pulmonary stenosis.

54
Q

What is the significance of the ‘Norwood procedure’ in cyanotic heart disease?

A

It is a staged surgical approach for hypoplastic left heart syndrome.

55
Q

What is the role of the ‘Bidirectional Glenn shunt’ in cyanotic heart disease?

A

It is the second stage of the Fontan procedure, improving oxygenation.

56
Q

What is the significance of the ‘Total Anomalous Pulmonary Venous Return’ (TAPVR)?

A

It is a cyanotic heart defect where pulmonary veins drain into the right atrium.

57
Q

What is the role of the ‘Mustard procedure’ in TGA?

A

It is an atrial switch procedure that redirects blood flow.

58
Q

What is the significance of the ‘Senning procedure’ in TGA?

A

It is another atrial switch procedure, less commonly used now.

59
Q

What is the role of the ‘Damus-Kaye-Stansel procedure’ in cyanotic heart disease?

A

It is used in complex defects to ensure systemic blood flow.

60
Q

What is the significance of the ‘Kawashima procedure’ in cyanotic heart disease?

A

It is a modification of the Fontan procedure for single ventricle physiology.

61
Q

What is the normal oxygen saturation level?

A

95-100%.

62
Q

What is polycythemia?

A

An increase in red blood cell count, often due to chronic hypoxia.

63
Q

What is a heart murmur?

A

An abnormal sound heard during a heartbeat, often due to valve issues.

64
Q

What is the role of the pulmonary artery?

A

To carry deoxygenated blood from the heart to the lungs.

65
Q

What is the role of the aorta?

A

To carry oxygenated blood from the heart to the body.

66
Q

What is the normal heart rate for adults?

A

60-100 beats per minute.

67
Q

What is the role of the ventricles in the heart?

A

To pump blood to the lungs (right ventricle) and the body (left ventricle).

68
Q

What is the role of the atria in the heart?

A

To receive blood from the body (right atrium) and the lungs (left atrium).

69
Q

What is the role of the mitral valve?

A

To prevent backflow of blood from the left ventricle to the left atrium.

70
Q

What is the role of the tricuspid valve?

A

To prevent backflow of blood from the right ventricle to the right atrium.

71
Q

What is the significance of a patent ductus arteriosus (PDA)?

A

It allows blood to bypass the lungs in fetal circulation but should close after birth.

72
Q

What is the role of prostaglandins in maintaining a PDA?

A

They keep the PDA open, which can be beneficial in certain congenital heart defects.

73
Q

What is the role of the foramen ovale in fetal circulation?

A

It allows blood to bypass the lungs by shunting from the right atrium to the left atrium.

74
Q

What is the significance of a ventricular septal defect (VSD)?

A

It allows blood to shunt between the ventricles, leading to mixing of oxygenated and deoxygenated blood.

75
Q

What is the role of the pulmonary valve?

A

To prevent backflow of blood from the pulmonary artery to the right ventricle.

76
Q

What is the role of the aortic valve?

A

To prevent backflow of blood from the aorta to the left ventricle.

77
Q

What is the significance of right ventricular hypertrophy?

A

It indicates increased pressure in the right ventricle, often due to pulmonary stenosis.

78
Q

What is the role of the coronary arteries?

A

To supply blood to the heart muscle.

79
Q

What is the role of the coronary arteries?

A

To supply oxygenated blood to the heart muscle.

80
Q

What is the significance of a heart transplant?

A

It is a treatment option for end-stage heart failure.

81
Q

What is the role of an electrocardiogram (ECG)?

A

To measure the electrical activity of the heart and diagnose arrhythmias.

82
Q

What is the pathophysiology of heart failure?

A

The heart cannot pump enough blood to meet the body’s needs, leading to fluid buildup and organ dysfunction.

83
Q

What is the role of natriuretic peptides in heart failure?

A

They are released in response to increased heart pressure and help regulate fluid balance.

84
Q

What is the significance of ejection fraction in heart failure?

A

It measures the percentage of blood ejected from the left ventricle with each heartbeat.

85
Q

What is the role of beta-blockers in heart failure?

A

They reduce heart rate and blood pressure, improving heart function.

86
Q

What is the role of ACE inhibitors in heart failure?

A

They reduce blood pressure and decrease the workload on the heart.

87
Q

What is the significance of pulmonary hypertension?

A

It increases pressure in the pulmonary arteries, leading to right heart failure.

88
Q

What is the role of diuretics in heart failure?

A

They reduce fluid buildup by increasing urine output.

89
Q

What is the significance of cardiac output?

A

It measures the amount of blood the heart pumps per minute.

90
Q

What is the role of the renin-angiotensin-aldosterone system (RAAS) in heart failure?

A

It regulates blood pressure and fluid balance but can worsen heart failure if overactive.

91
Q

What is the significance of a myocardial infarction?

A

It is a heart attack caused by blocked blood flow to the heart muscle.

92
Q

What is the role of the sinoatrial (SA) node?

A

It is the heart’s natural pacemaker, initiating electrical impulses.

93
Q

What is the role of the atrioventricular (AV) node?

A

It delays electrical impulses to allow the atria to contract before the ventricles.

94
Q

What is the role of the bundle of His?

A

It conducts electrical impulses from the AV node to the ventricles.

95
Q

What is the role of the Purkinje fibers?

A

They distribute electrical impulses throughout the ventricles.

96
Q

What is the significance of an arrhythmia?

A

It is an abnormal heart rhythm that can affect heart function.

97
Q

What is the role of defibrillation in treating arrhythmias?

A

It delivers an electric shock to restore normal heart rhythm.

98
Q

What is the role of anticoagulants in heart disease?

A

They prevent blood clots, reducing the risk of stroke or heart attack.

99
Q

What is the significance of cholesterol in heart disease?

A

High levels can lead to plaque buildup in arteries, increasing the risk of heart disease.

100
Q

What is the role of statins in heart disease?

A

They lower cholesterol levels, reducing the risk of heart disease.

101
Q

What is the significance of a healthy diet in preventing heart disease?

A

It reduces risk factors like high cholesterol, high blood pressure, and obesity.

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