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42 Cards in this Set

  • Front
  • Back
What are the essential structures to evaluate on a chest xray for chd?
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.
What are causes of increased Arterial Flow
4 main things with one more
ASD, VSD, PDA, PAPVR, Endocardial cushion defect (remember big ropes in the chest xray, not haziness)
What are the causes decreased arterial flow?
TET, Tricuspid atresia, Hypoplastic left heart syndrome, PS, Ebsteins anomaly of the tricuspid valve. ALL are right heart obstructions.
What is the definition of cyanosis?
o2 sat <85%
What are the Cyanotic Teasers?
5 teasers
2.Truncus arteriosus
3. Transposition of the great vessels
4. Tricuspid atresia
What are the causes of Venous Obstruction
ALL 9 are "left heart" obstructions
1. Coarct
2. AV stenosis
4. Congenital Mitral stenosis
5. Cor triatriatum
6. Hypoplastic left heart
8. Endocardial fibroelastosis
9. Anomalous origin of the LCA
What causes Increased Pulmonary vessel Flow in cyanosis?
The three terrible T's
1. Transposition of the GV
2. Truncus Arteriosus
What are potential causes normal pulmonary vessels in CHD?
1. AS
2. Coarct
3. Pulmonary valv stenosis (isolated)
4. Interruption of the aortic arch
5. Peripheral pulmonary artery stenosis (rubella)
What does it imply if Apex of the heart is Up and out or down and out?
Up and Out is RVH
Down and out is LVH
Causes of big heart with inc pulm art (shunt to lungs)?
ASD, PAPVR/Scimitar
Causes of enlarged LA with shunt to lungs (inc pulm art)
vsd OR PDA
Cause of biatrial enlargement?
ECD or AV canal defect
What can 2 manubrial ossification centers be seen in?
Downs, and count ribs, if there are 11 pairs, likely downs.
When do you know there is no vascular ring?
When there is a solitary left aortic arch with normal situs.
Where is the normal PA conflunce on a frontal view?
To the left of the spine
What do you think of when you see medial displacement of the PA?
Truncus or Transposition.
What are the characteristics of D-TGV?
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.
What are the charactersitics of L-TGV?
Think of it as
"Ventricular Inversion" or "Corrected transposition" Ventricles are switched, otherwise normal.

What always goes with the RV?
What is concordance and discordance?
When Arch, cardiac apex, and stomach bubble are all on the SAME side it is concordant. If not it is discordant.
What is Situs solitus and inversus?
Solitus means arch, apex and stomach bubble on the correct side. Inversus means ALL on the right.
What is the signficance of discordance?
More complex chd.
What is associated with polysplenia?
What happens in Blalock-Taussig repair? Modified?
Subclav artery to pulm artery, modified is the same but graft goes between the two.
What happens in a Rashkind?
Atrial Balloon Septostomy.
What happens in a Mustard and Senning procedure?
Atrial septectomy and baffle for transpositions.
What happens in a Rastelli?
Valved conduit from RV to PA
What happens in a fontan?
Conduit from RA to PA
What happens in a Jatene?
Arterial switch for Transpositions
What happens in a Glenn?
What happens in a Damus?
Proximal PA to aorta + fontan or rastelli
What happens in a norwood?
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
What happens in a Ross?
Replace aorta with native PA add conduit for PA
What is difference between Rastelli vs Fontan?
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.
What are the genearl causes of acquired small heart disease?
Pressure overload lesions or lesions that reduce ventricular compliance.
What are casues of acquired large heart disease?
Volume overload lesions and myocardial failure
Causes of acquired small heart disease with LAE?
Mitral Stenosis
Reduced LV compliance
-Restrictive CM
-Hypertrophic or constrictive pericarditis
Causes of acquired small heart disease with AoE?
Aortic Stenosis
Causes of acquired small heart disease without AoE or LAE?
Myocardial and Pericardial constrictive causes
-Acute MI
-Restrictive CM
-Hypertrophic CM
-Constrictive Pericarditis
Causes of aquired big heart disease with LAE?
Causes of acquired big heart deisease with AoE?
Aortic regurg
Causes of Acquired ig heart disease without AoE or LAE?
-Dilated CM
-Ischemic CM
-Pericardial effusion
-Tricuspid regurg
-RV failure.