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39 Cards in this Set
- Front
- Back
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timing of congenital HD |
weeks 3-8 |
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genetic congenital HD |
Trisomies 13, 15, 18, 21, turner syndrome |
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environmental congenital HD |
congenital rubella |
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fetal right atrium |
slight mixing of deoxygenated and oxygenated blood
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fetal Inferior vena cava |
bring oxygenated blood from the placenta |
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path of oxygenated blood flow |
placenta -> IVC -> foramen ovale -> left atrium -> left ventricle -> aorta -> body |
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fetal superior vena cava |
brings deoxygenated blood from the upper body |
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path of deoxygenated blood in fetus |
upper body -> SVC -> right ventricle -> pulmonary artery -> small amount to lungs, rest through ductus arteriosus -> aorta |
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Left to right shunts |
oxygenated blood moves from L->R = incr. volume in right atrium and ventricle = right sided Hypertrophy = pulmonary HTN = eventually leads to R->L shunting and cyanosis |
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Atrial septal defects |
Left to right shunt, 3 types: secundum (90%), primum (assoc. w/ cleft mitral valve), sinus venosus (connections of right pulmonary veins) |
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Atrial septal defects shunt |
left to right; pulmonary blood flow 2-4 times normal well tolerated until 30s, <10% develop pulmonary HTN |
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ASD complications |
systolic murmur due to blood flow across pulmonic valve, arrhythmias |
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Ventricular septal defect |
incomplete closure of the ventricular septum, many assoc. w/ other defects (tetralogy) membranous portion most common (90%) many spontaneous close over time esp. muscular |
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symptomatic VSD |
size of aortic orifice |
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VSD shunt |
left to right = RV hypertrophy and pulmonary HTN leads to shunt reversal, cyanosis and death |
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complications of large VSD |
recurrent pneumonia, chronic resp. Sx, exercise intolerance, FTT, endocarditis, murmurs |
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Atrioventricular septal defect |
incomplete fusion of endocardial cushions leads to a low ASD, high VSD, and incomplete formation of mitral and tricuspid valves |
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partial AV septal defect |
primary ASD and cleft anterior mitral leaflet |
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complete AV septal defect |
common AV valve |
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AV septal defect association |
1/3 have Down's syndrome |
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Patent ductus arteriosus |
90% isolated; continuous harsh murmur left to right shunt (aorta to pulmonary artery) shunt reversal due to obstructive pulmonary vascular dz |
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Right to left shunts sx |
think cyanosis!! other sx: clubbing and polycythemia |
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Right to left shunts |
The "T's" = tetralogy of Fallot, transposition, persistent truncus arteriosus, tricuspid atresia |
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Tetralogy of Fallot |
VSD, subpulmonary stenosis, aorta that overrides the VSD, right ventricular hypertrophy |
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Transposition of Great Vessels |
abnormal formation of truncal and aortopulmonary septa, so aorta arises from RV and lies anterior and to right of pulm. artery |
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35% of transposition patients also have |
VSD (stable) |
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transposition + patent foramen ovale or ductus arteriosus |
unstable shunt |
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transposition presents with |
right ventricular hypertrophy |
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Truncus Arteriosus |
failure of separation into aorta and pulmonary artery |
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Tricuspid atresia cause |
unequal division of the AV canal + underdevelopment of the right ventricle ASD or VSD |
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Tricuspid atresia |
valve doesn't develop, so no link b/t right atrium and right ventricle |
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defects assoc. with tricuspid atresia |
septal defect, hypoplastic or absent RV, enlarged mitral valve and left ventricle, pulmonic stenosis |
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Total anomalous pulmonary venous connection |
no pulmonary veins directly joins the left atrium b/c common pulmonary vein doesn't develop |
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Total anomalous pulmonary venous connection assoc. defect |
ASD or patent foramen ovale |
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coarctation of aorta |
2:1 males, two forms - infantile and adult 50% accompanied by bicuspid aortic valve |
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infantile coarctation of aorta |
hypoplasia of aorta proximal to PDA (worse prognosis) |
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adult coarctation of aorta |
hypoplasia of aorta distal to ductus - more common, less serious |
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aortic stenosis and atresia |
valvular (hypoplastic, dysplastic, abnormal in normal), sub- or supravalvular |
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Hypoplastic left heart syndrome (HLHS) |
underdeveloped left side of the heart must have a PDA to allow blood to get to systemic circulation pass the narrowed aorta |
