Chd

Front 1

What are the essential structures to evaluate on a chest xray for chd?

Back 1

4 things.
1. Is the box normal (chest)
2. Is the pulmonary vasc increased or not (look through heart)
3. Heart-size, Chamber analysis (any enlarged, contours off)
4. Where are the great vessels.

Front 2

What are causes of increased Arterial Flow

Back 2

4 main things with one more
ASD, VSD, PDA, PAPVR, Endocardial cushion defect (remember big ropes in the chest xray, not haziness)

Front 3

What are the causes decreased arterial flow?

Back 3

TET, Tricuspid atresia, Hypoplastic left heart syndrome, PS, Ebsteins anomaly of the tricuspid valve. ALL are right heart obstructions.

Front 4

What is the definition of cyanosis?

Back 4

o2 sat <85%

Front 5

What are the Cyanotic Teasers?

Back 5

5 teasers
1.TET
2.Truncus arteriosus
3. Transposition of the great vessels
4. Tricuspid atresia
5. TAPVR

Front 6

What are the causes of Venous Obstruction

Back 6

ALL 9 are "left heart" obstructions
1. Coarct
2. AV stenosis
3. IHSS
4. Congenital Mitral stenosis
5. Cor triatriatum
6. Hypoplastic left heart
7. TAPVR
8. Endocardial fibroelastosis
9. Anomalous origin of the LCA

Front 7

What causes Increased Pulmonary vessel Flow in cyanosis?

Back 7

The three terrible T's
1. Transposition of the GV
2. Truncus Arteriosus
3. TAPVR

Front 8

What are potential causes normal pulmonary vessels in CHD?

Back 8

1. AS
2. Coarct
3. Pulmonary valv stenosis (isolated)
4. Interruption of the aortic arch
5. Peripheral pulmonary artery stenosis (rubella)

Front 9

What does it imply if Apex of the heart is Up and out or down and out?

Back 9

Up and Out is RVH
Down and out is LVH

Front 10

Causes of big heart with inc pulm art (shunt to lungs)?

Back 10

ASD, PAPVR/Scimitar

Front 11

Causes of enlarged LA with shunt to lungs (inc pulm art)

Back 11

vsd OR PDA

Front 12

Cause of biatrial enlargement?

Back 12

ECD or AV canal defect

Front 13

What can 2 manubrial ossification centers be seen in?

Back 13

Downs, and count ribs, if there are 11 pairs, likely downs.

Front 14

When do you know there is no vascular ring?

Back 14

When there is a solitary left aortic arch with normal situs.

Front 15

Where is the normal PA conflunce on a frontal view?

Back 15

To the left of the spine

Front 16

What do you think of when you see medial displacement of the PA?

Back 16

Truncus or Transposition.

Front 17

What are the characteristics of D-TGV?

Back 17

D is the "Thee" transposition. Great vessels are switched. Patient is dead unless asd, vsd, pda

Right heart goes out to systemic circ and left heart circulates with lungs.

Front 18

What are the charactersitics of L-TGV?

Back 18

Think of it as
"Ventricular Inversion" or "Corrected transposition" Ventricles are switched, otherwise normal.

RA->LV>PA->Lungs-->LA->RV->Aorta

Front 19

What always goes with the RV?

Back 19

Infundibulum

Front 20

What is concordance and discordance?

Back 20

When Arch, cardiac apex, and stomach bubble are all on the SAME side it is concordant. If not it is discordant.

Front 21

What is Situs solitus and inversus?

Back 21

Solitus means arch, apex and stomach bubble on the correct side. Inversus means ALL on the right.

Front 22

What is the signficance of discordance?

Back 22

More complex chd.

Front 23

What is associated with polysplenia?

Back 23

Dextro VERSION

Front 24

What happens in Blalock-Taussig repair? Modified?

Back 24

Subclav artery to pulm artery, modified is the same but graft goes between the two.

Front 25

What happens in a Rashkind?

Back 25

Atrial Balloon Septostomy.

Front 26

What happens in a Mustard and Senning procedure?

Back 26

Atrial septectomy and baffle for transpositions.

Front 27

What happens in a Rastelli?

Back 27

Valved conduit from RV to PA

Front 28

What happens in a fontan?

Back 28

Conduit from RA to PA

Front 29

What happens in a Jatene?

Back 29

Arterial switch for Transpositions

Front 30

What happens in a Glenn?

Back 30

SVC to PA

Front 31

What happens in a Damus?

Back 31

Proximal PA to aorta + fontan or rastelli

Front 32

What happens in a norwood?

Back 32

complex 3 stage for HLH.
1. Proximal PA to hypoplastic aorta + B-T shunt
2. Glenn, B-T Taken down (6-12 months later)
3. Conert Glenn to Fontan at 2 yo

Front 33

What happens in a Ross?

Back 33

Replace aorta with native PA add conduit for PA

Front 34

What is difference between Rastelli vs Fontan?

Back 34

Valved Conduit in Rastelli, no Valve in Fontan. Also, RV skipped in Fontan, just RA to PA. Both used for obstructing lesion on Right side of the heart.

Front 35

What are the genearl causes of acquired small heart disease?

Back 35

Pressure overload lesions or lesions that reduce ventricular compliance.

Front 36

What are casues of acquired large heart disease?

Back 36

Volume overload lesions and myocardial failure

Front 37

Causes of acquired small heart disease with LAE?

Back 37

Mitral Stenosis
Reduced LV compliance
-Restrictive CM
-Hypertrophic or constrictive pericarditis

Front 38

Causes of acquired small heart disease with AoE?

Back 38

Aortic Stenosis

Front 39

Causes of acquired small heart disease without AoE or LAE?

Back 39

Myocardial and Pericardial constrictive causes
-Acute MI
-Restrictive CM
-Hypertrophic CM
-Constrictive Pericarditis

Front 40

Causes of aquired big heart disease with LAE?

Back 40

MR

Front 41

Causes of acquired big heart deisease with AoE?

Back 41

Aortic regurg

Front 42

Causes of Acquired ig heart disease without AoE or LAE?

Back 42

-Dilated CM
-Ischemic CM
-Pericardial effusion
-Tricuspid regurg
-RV failure.