Tga Flashcards
What is Transposition of the Great Arteries (TGA)?
A congenital heart defect where the aorta arises from the right ventricle and the pulmonary artery from the left ventricle.
What are the two isolated circulations in TGA?
Systemic and pulmonary circulations, which are separate and incompatible with life without communication.
Why is communication between circulations necessary in TGA?
To allow mixing of oxygenated and deoxygenated blood for survival.
What is the clinical presentation of TGA at birth?
Central cyanosis, which is deep and seen in the tongue, lips, and limbs.
What is the role of the ductus arteriosus in TGA?
It provides a temporary communication between the systemic and pulmonary circulations.
What are the symptoms of TGA in infants?
Cyanosis, dyspnea, feeding difficulties, and failure to thrive.
What is the significance of cardiomegaly in TGA?
It indicates an enlarged heart due to increased workload.
What is the ‘Egg on side’ appearance on chest X-ray in TGA?
A characteristic heart shape seen in TGA due to the abnormal position of the great vessels.
What is the role of echocardiography in diagnosing TGA?
It confirms the abnormal connection of the great vessels and assesses heart function.
What is the treatment for TGA in newborns?
Prostaglandin infusion to keep the ductus arteriosus open and urgent surgical correction.
What is the pathophysiology of cyanosis in TGA?
Oxygenated blood circulates only in the lungs, and deoxygenated blood circulates in the body, leading to systemic desaturation.
What is the role of an atrial septostomy in TGA?
It creates a communication between the atria to allow mixing of blood.
What is the significance of the ‘Boot-shaped’ heart on chest X-ray?
It is seen in Tetralogy of Fallot, not TGA, and indicates right ventricular hypertrophy.
What is the role of the Rashkind procedure in TGA?
It is a balloon atrial septostomy to create a communication between the atria.
What is the arterial switch operation in TGA?
A surgical procedure to correct TGA by switching the aorta and pulmonary artery to their correct positions.
What are the complications of untreated TGA?
Heart failure, recurrent chest infections, and brain abscess due to chronic hypoxia.
What is the significance of polycythemia in TGA?
It is a response to chronic hypoxia, increasing the risk of thrombosis.
What is the role of cardiac catheterization in TGA?
It can be used for diagnosis and treatment, such as performing an atrial septostomy.
What is the significance of a narrow cardiac waist on chest X-ray in TGA?
It is due to the abnormal position of the great vessels.
What is the role of prostaglandins in TGA?
They keep the ductus arteriosus open, allowing temporary mixing of blood.
What is the embryological cause of TGA?
Failure of the aorticopulmonary septum to spiral during development.
What is the significance of the ‘Egg on string’ appearance on chest X-ray in TGA?
It is due to the abnormal position of the great vessels and the narrow mediastinum.
What is the role of the left ventricle in TGA before and after the arterial switch operation?
Before surgery, the left ventricle pumps blood to the lungs; after surgery, it pumps blood to the body.
What is the significance of the ‘Mustard’ or ‘Senning’ procedure in TGA?
They are atrial switch procedures that redirect blood flow but are less commonly used now.
What is the role of the coronary arteries in the arterial switch operation?
They must be reimplanted into the new aorta to ensure proper blood supply to the heart.
What is the significance of pulmonary congestion in TGA?
It indicates increased blood flow to the lungs, often due to a large VSD.
What is the role of the right ventricle in TGA before and after the arterial switch operation?
Before surgery, the right ventricle pumps blood to the body; after surgery, it pumps blood to the lungs.
What is the significance of the ‘Jatene procedure’ in TGA?
It is another name for the arterial switch operation.
What is the role of the foramen ovale in TGA?
It provides a temporary communication between the atria, allowing some mixing of blood.
What is the significance of the ‘Blalock-Taussig shunt’ in TGA?
It is a palliative procedure to increase pulmonary blood flow in cyanotic heart defects.
What is cyanotic heart disease?
Congenital heart defects that cause low oxygen levels in the blood, leading to cyanosis.
What are the common cyanotic heart diseases?
Tetralogy of Fallot, Transposition of the Great Arteries, and Tricuspid Atresia.
What is the clinical presentation of cyanotic heart disease?
Cyanosis, clubbing, and failure to thrive.
What is the significance of clubbing in cyanotic heart disease?
It is a sign of chronic hypoxia.
What is the role of echocardiography in cyanotic heart disease?
It helps diagnose the specific defect and assess heart function.
What is the significance of polycythemia in cyanotic heart disease?
It is a response to chronic hypoxia, increasing the risk of thrombosis.
What is the role of oxygen therapy in cyanotic heart disease?
It can temporarily improve oxygen levels but does not correct the underlying defect.
What is the significance of squatting in Tetralogy of Fallot?
It increases systemic vascular resistance, reducing right-to-left shunting and improving oxygenation.
What is the role of the Blalock-Taussig shunt in cyanotic heart disease?
It increases pulmonary blood flow in defects like Tetralogy of Fallot.
What is the significance of the ‘Boot-shaped’ heart on chest X-ray?
It is seen in Tetralogy of Fallot due to right ventricular hypertrophy.
What is the pathophysiology of cyanosis in Tetralogy of Fallot?
Right-to-left shunting through the VSD leads to systemic desaturation.
What is the role of the VSD in Tetralogy of Fallot?
It allows right-to-left shunting, leading to cyanosis.
What is the significance of pulmonary stenosis in Tetralogy of Fallot?
It restricts blood flow to the lungs, increasing right-to-left shunting.
What is the role of the right ventricle in Tetralogy of Fallot?
It hypertrophies to overcome pulmonary stenosis.
What is the significance of the ‘Tet spell’ in Tetralogy of Fallot?
It is a sudden episode of cyanosis and breathlessness due to increased right-to-left shunting.
What is the role of beta-blockers in Tetralogy of Fallot?
They reduce the frequency of ‘Tet spells’ by decreasing right ventricular outflow obstruction.
What is the significance of the ‘Waterston shunt’ in cyanotic heart disease?
It is a palliative procedure to increase pulmonary blood flow.
What is the role of the ‘Potts shunt’ in cyanotic heart disease?
It connects the descending aorta to the pulmonary artery, increasing pulmonary blood flow.
What is the significance of the ‘Glenn shunt’ in cyanotic heart disease?
It directs blood from the superior vena cava to the pulmonary artery, improving oxygenation.
What is the role of the ‘Fontan procedure’ in cyanotic heart disease?
It directs blood from the inferior vena cava to the pulmonary artery, completing the separation of circulations.
What is the embryological cause of Tetralogy of Fallot?
Anterior deviation of the infundibular septum during development.
What is the significance of the ‘Eisenmenger syndrome’ in cyanotic heart disease?
It is a complication where left-to-right shunting reverses due to pulmonary hypertension.
What is the role of the ‘Rastelli procedure’ in cyanotic heart disease?
It is a surgical correction for defects like TGA with VSD and pulmonary stenosis.
What is the significance of the ‘Norwood procedure’ in cyanotic heart disease?
It is a staged surgical approach for hypoplastic left heart syndrome.
What is the role of the ‘Bidirectional Glenn shunt’ in cyanotic heart disease?
It is the second stage of the Fontan procedure, improving oxygenation.
What is the significance of the ‘Total Anomalous Pulmonary Venous Return’ (TAPVR)?
It is a cyanotic heart defect where pulmonary veins drain into the right atrium.
What is the role of the ‘Mustard procedure’ in TGA?
It is an atrial switch procedure that redirects blood flow.
What is the significance of the ‘Senning procedure’ in TGA?
It is another atrial switch procedure, less commonly used now.
What is the role of the ‘Damus-Kaye-Stansel procedure’ in cyanotic heart disease?
It is used in complex defects to ensure systemic blood flow.
What is the significance of the ‘Kawashima procedure’ in cyanotic heart disease?
It is a modification of the Fontan procedure for single ventricle physiology.
What is the normal oxygen saturation level?
95-100%.
What is polycythemia?
An increase in red blood cell count, often due to chronic hypoxia.
What is a heart murmur?
An abnormal sound heard during a heartbeat, often due to valve issues.
What is the role of the pulmonary artery?
To carry deoxygenated blood from the heart to the lungs.
What is the role of the aorta?
To carry oxygenated blood from the heart to the body.
What is the normal heart rate for adults?
60-100 beats per minute.
What is the role of the ventricles in the heart?
To pump blood to the lungs (right ventricle) and the body (left ventricle).
What is the role of the atria in the heart?
To receive blood from the body (right atrium) and the lungs (left atrium).
What is the role of the mitral valve?
To prevent backflow of blood from the left ventricle to the left atrium.
What is the role of the tricuspid valve?
To prevent backflow of blood from the right ventricle to the right atrium.
What is the significance of a patent ductus arteriosus (PDA)?
It allows blood to bypass the lungs in fetal circulation but should close after birth.
What is the role of prostaglandins in maintaining a PDA?
They keep the PDA open, which can be beneficial in certain congenital heart defects.
What is the role of the foramen ovale in fetal circulation?
It allows blood to bypass the lungs by shunting from the right atrium to the left atrium.
What is the significance of a ventricular septal defect (VSD)?
It allows blood to shunt between the ventricles, leading to mixing of oxygenated and deoxygenated blood.
What is the role of the pulmonary valve?
To prevent backflow of blood from the pulmonary artery to the right ventricle.
What is the role of the aortic valve?
To prevent backflow of blood from the aorta to the left ventricle.
What is the significance of right ventricular hypertrophy?
It indicates increased pressure in the right ventricle, often due to pulmonary stenosis.
What is the role of the coronary arteries?
To supply blood to the heart muscle.
What is the role of the coronary arteries?
To supply oxygenated blood to the heart muscle.
What is the significance of a heart transplant?
It is a treatment option for end-stage heart failure.
What is the role of an electrocardiogram (ECG)?
To measure the electrical activity of the heart and diagnose arrhythmias.
What is the pathophysiology of heart failure?
The heart cannot pump enough blood to meet the body’s needs, leading to fluid buildup and organ dysfunction.
What is the role of natriuretic peptides in heart failure?
They are released in response to increased heart pressure and help regulate fluid balance.
What is the significance of ejection fraction in heart failure?
It measures the percentage of blood ejected from the left ventricle with each heartbeat.
What is the role of beta-blockers in heart failure?
They reduce heart rate and blood pressure, improving heart function.
What is the role of ACE inhibitors in heart failure?
They reduce blood pressure and decrease the workload on the heart.
What is the significance of pulmonary hypertension?
It increases pressure in the pulmonary arteries, leading to right heart failure.
What is the role of diuretics in heart failure?
They reduce fluid buildup by increasing urine output.
What is the significance of cardiac output?
It measures the amount of blood the heart pumps per minute.
What is the role of the renin-angiotensin-aldosterone system (RAAS) in heart failure?
It regulates blood pressure and fluid balance but can worsen heart failure if overactive.
What is the significance of a myocardial infarction?
It is a heart attack caused by blocked blood flow to the heart muscle.
What is the role of the sinoatrial (SA) node?
It is the heart’s natural pacemaker, initiating electrical impulses.
What is the role of the atrioventricular (AV) node?
It delays electrical impulses to allow the atria to contract before the ventricles.
What is the role of the bundle of His?
It conducts electrical impulses from the AV node to the ventricles.
What is the role of the Purkinje fibers?
They distribute electrical impulses throughout the ventricles.
What is the significance of an arrhythmia?
It is an abnormal heart rhythm that can affect heart function.
What is the role of defibrillation in treating arrhythmias?
It delivers an electric shock to restore normal heart rhythm.
What is the role of anticoagulants in heart disease?
They prevent blood clots, reducing the risk of stroke or heart attack.
What is the significance of cholesterol in heart disease?
High levels can lead to plaque buildup in arteries, increasing the risk of heart disease.
What is the role of statins in heart disease?
They lower cholesterol levels, reducing the risk of heart disease.
What is the significance of a healthy diet in preventing heart disease?
It reduces risk factors like high cholesterol, high blood pressure, and obesity.
