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87 Cards in this Set

  • Front
  • Back
The most common cause of heart disease in children in the Western world
congenital heart disease
3 major groups of congenital heart disease
L to R shunt
R --> L shunt
cyanotic congenital heart disease is part of which group?
right to left shunt
infective endocarditis is common to which major group of congenital HD
all 3
the most common type of congenital malformation
left to right shunt
what specific malformations cause L to R shunts?
What is "tardive cyanosis"?
when a left to right shunt flow reverses
most common type of ASD (75%)
ostium secundum ASD
(septum secundum fails to cover the ostium scundum)
second mos common type of ASD (15%)
ostium primum ASD
(septum primum does not fuse with endocardial cushion)
least common type of ASD (10%)
sinus venosus ASD
where are sinus venosus ASDs?
high in the atrial septum
(rare picture of both ostia in one heart)
which is the ostium primum ASD?
most common congenital heart malformations diagnosed in adults
(b/c many VSDs close spontaneously)
Most common congenital heart malformations in general
Ostium Primum ASDs are more likely assoc with CHF b/c of high frequency of _________ insufficiency
Clinical signs of ASD
- wide fixed split P2 with pulmonary flow murmur
- pulmonary vasculature normal to increased
- Eisenmenger's syndrome
Type of ASD that is well-tolerated, especially if it is less than 1cm diameter.
ostium secundum
(pulmonary HTN develops slowly and shunt reverses --> cyanosis)
most common congenital heart lesion at birth
where are the basal (membranous) and muscular parts of the ventricular septum
Membranous part grows from endocardial cushions
Muscular part grows up from apex
Site where 70% of VSDs are located
in the thinner membranous part of the septum
murmur type heard with VSD
genetic diseases associated with VSD
Trisomy 21, 13, 18
____% of VSD cases occur alone w/o other malfomations
___% of VSD pts develop Eisenmenger's snyndrome
small or medium sized VSDs that produce jet lesions have the risk of __________
superimposed infective endocarditis
The 6th most common congenital Heart disease :)
(10% of all cardiac malformations)
What makes the ductus constrict after birth?
1-increased levels of arterial oxygen,
2-decreasing pulmonary vascular resistance, and
3-declining levels of prostaglandin E2
Membranous (basal)
What type of VSD
PDA is more common in females, T or F?
murmur heard with PDA
machine-like, continuous, waxing and waning
2 distinct presentations of PDA
1- premature infants in postnatal period
2- term infants at 3 months
What would delay closure of the ductus after birth
hypoxia, resp. distress, heart disease
There is higher incidence of PDA in the presence of maternal _________ infection.
polycythemia is associated with what congenital heart disease?
Treatment of PDA
- surgical correction (cure)
- coil occlusion
- indomethacin in premies (80% success)
right to left shunts (4)
1- tetralogy of Fallot
2- transposition of the great vessels
3- tricuspid atresia
4- total anomalous pulonary venous connection (TAPVC)
cyanotic heart defects at birth
the Ts and Truncus Arteriosus
Cyanotic heart defects after birth, when right-sided pressure increases
the most common cause of cyanotic heart disease
tetralogy of Fallot
The four components of the tetralogy are ________
(1) a VSD,
(2) a "dextraposed" aortic root that overrides the VSD, (3) right ventricular outflow obstruction, and
(4) right ventricular hypertrophy
What genetic disease is assoc. with Tetralogy of Fallot?
Down syndrome
What is the most likely lesion in a pt w/ right-sided arch and cyanosis
tetralogy of Fallot
Tetralogy of Fallot accounts for ____% of all congenital cardiac malformations
Shape of heart in tetralogy of Fallot
describe the proximal aortic root in tetralogy of Fallot
describe pulmonary trunk in tetralogy of Fallot
small with narrowing or stenosis
When does pulmonary HTN start in Tetralogy of Fallot?
Effects of chronic cyanosis
-hyperviscosity secondary to erythrocytosis
-digital clubbing
-systemic embolism
the 2nd leading cause of cyanotic heart disease
patients with tetralogy of Fallot are also at increased risk for infective endocarditis, systemic emboli, and _________.
brain abscesses
the 2nd leading cause of cyanotic heart disease
patients with tetralogy of Fallot are also at increased risk for infective endocarditis, systemic emboli, and _________.
brain abscesses
treatment of transposition
prostaglandin E2, balloon septostomy and the creation of shunts, followed by definitive surgical correction
Truncus arteriosus is ___% of congenital heart malformations
Truncus arteriosus is a R to L shunt with heart failure and _________ infections
respiratory tract
Is truncus arteriosus correctable with surgery?
complete occlusion of the tricuspid valve
tricuspid atresia
(not discussed in Robbins 7th ed)
For tricuspid atresia to allow life, what malforamtions are present?
ASD, VSD (for the great artery communication in RV)
(not in Robbins 7th ed)
Condition where no pulmonary veins directly join the left atrium
total anomalous pulmonary vascular connections
Instead of from the pulmonary veins, the left atrium gets blood how?
Blood goes from coronary sinus --> to right atrium
--> ASD or patent foramen ovale
--> Left atrium
congeniatl obstructive lesions (2)
coarctation of aorta
valvular stenosis
coarctation of the aorta is more common in the ____ gender and also _____ syndrome

Turner syndrome
coarctaion of the aorta is associated with ______ aneurysms of the CNS
most common type of coarctation of aorta
narrowing of the aortic isthmus
preductal coarctation ("infantile")
type of aortic coarctation wherer ductus is patent
type of aortic coarctation with LVH
RV is enlarged and there is abnormal septal and posterior tricuspid leaflets
Ebstein's anomaly
Ebstein's anomaly may be familial or associated with maternal _______ ingestion
condition that occurs with redundant and fenestrated leaflet
Ebstein's anomaly
condition that occurs with conduction abnormalities (Wolf-Parkinson-white syndrome)
Ebstein's anomaly
condition that causes atrialization of apical right ventricle
Ebstein's anomaly
treatment of Ebstein's anomaly
-valvuloplasty and RV reduction
-tricuspid valve replacement
-ablation of conduction bypass pathways
-antiarrythmia agents
clinical presentation of Ebstein's anomaly
13th most common CHD
hypoplastic left heart syndromes
a group of disorders characterized by underdeveloped left cardiac chambers
hypoplastic left heart syndromes
syndromes with marked cardiomegaly and increased pulmonary vascularity
Also, life depends on ductus areteriosus
hypoplastic left heart syndromes
Clinical presentation of hypoplastic left heart syndromes
poor CO,
poor appetite and hypoglycemia,
eventual IHD,
maybe shock
treatment of hypoplastic left heart syndromes?
treat the acidosis and shock.

need surgery or transplant
In severe cases the ostium primum defect is accompanied by a VSD and severe mitral and tricuspid valve deformities, with a resultant common ________
atrioventricular canal
69% of folks with atrioventricular canal have _______ syndrome
heart is a mirror image of normal; sometimes assoc. with situs inversus
3 types of congenital HD
L-R, R-L, obstruction
most common type (of 3) of Congenital HD
left to right shunts
what are right to left shunts due to?
the T's;
tetralogy, transposition, TA, TAPVC
COndition with abnormal tricuspid valve leaflets
Ebstein's anomaly
an endocardial cushion defect with failure to form a variety of structures
AV canal