• Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

Card Range To Study

through

image

Play button

image

Play button

image

Progress

1/92

Click to flip

Use LEFT and RIGHT arrow keys to navigate between flashcards;

Use UP and DOWN arrow keys to flip the card;

H to show hint;

A reads text to speech;

92 Cards in this Set

  • Front
  • Back
What is the most common type of heart defect? What developmental failure causes this defect?
A membranous septum VSD; failure of the endocardial cushions to fuse with the muscular IV septum.
What four anatomical defects are associated with Tetralogy of Fallot?
S: Stenosis of the pulmonary artery
H: hypertrophy of the right ventricle
O: Overriding aorta
V: VSD
L to R Shunts (4)
ASD, VSD, PDA, AVSD (Think 4 D's)
R to L Shunts (5)
Tetralogy of Fallot; Transposition of Great Vessels; Truncus Arteriosus; Tricuspid Atresia; Total Anomalous Pulmonary Venous Return (TAPV); Think 5 T's
What do children with R to L shunts do to increase systemic vascular resistance?
Squat
What is the most common type of heart defect? What developmental failure causes this defect?
A membranous septum VSD; failure of the endocardial cushions to fuse with the muscular IV septum.
What four anatomical defects are associated with Tetralogy of Fallot?
S: Stenosis of the pulmonary artery
H: hypertrophy of the right ventricle
O: Overriding aorta
V: VSD
L to R Shunts (4)
ASD, VSD, PDA, AVSD (Think 4 D's)
R to L Shunts (5)
Tetralogy of Fallot; Transposition of Great Vessels; Truncus Arteriosus; Tricuspid Atresia; Total Anomalous Pulmonary Venous Return (TAPV); Think 5 T's
What do children with R to L shunts do to increase systemic vascular resistance?
Squat
Compression of Femoral Arteries yields increase in systemic pressure to decrease R to L shunt and increase flow to lungs.
What is the etiology of transposition of great vessels?
Failure of the aorticopulmonary septum to spiral.
What is the characteristic murmur of PDA?
Continuous machine-like murmur
holosystolic murmur
MR; TR; VSD
What is Total Anomalous Pulmonary Venous Connection (TAPVC)?
No pulmonary veins directly join the left atrium
Fetal Circulation
What supplies oxygen and nutrients from the placenta?
umbilical vein
What are two types of congenital heart defects
Acyanotic
Cyanotic
With acynotic defects what 2 things happen to the blood?
increased pulmonary flow
obstruction of blood flow out of the heart
With increased oxygen what happens to the pulmonary pressure?
decreased (vasodilation)
Mixed blood flow (4)
AV Canal
Transportation of the great vessels
Truncus arteriosus
Hypoplastic Left Heart Syndrome
Increased pulmonary blood flow (3)
Atrial and ventricular septal defects
Patent ductus arteriosis
CHF
Inability of the heart to pump enough blood to meet the body's metabolic and O2 needs - usually occurs as a complication of major cardiovascular or respiratory disorders
PDA

When does the left to right shunting occur?
both systole and diastole
Patent Ductus Arteriosus (PDA)

Occurs twice as often in _________ as in _________
girls
boys
PDA may be closed medically with __________________, which blocks prostaglandins.

What can be used as an alternative?
Indomethicine
Ibuprofen
What are the 4 main circulatory changes at birth?
1. pulmonary vasodilation
2. systemic pressure rises, pulmonary pressure falls
3. closure of the foramen ovale
4. closure of the ductus arteriosus and ductus venosum
How are Congenital Defects Classified (2)?
1. Acyanotic: disorders where there is an increase of pulmonary blood flow or obstruction of blood flow from a ventricle
2) Cyanotic: disorders where there is a decrease in pulmonary blood flow or mixed blood flow
What are 5 post-op complications for pts with atrioventricular canal defect?
1. heart block
2. chf
3. mitral regurgitation
4. dysrhythmias
5. pulmonary hypertension
Describe defects with increased pulmonary blood flow
Increased blood volume on the right side of the heart increases pulmonary blood flow at the expense of systemic blood flow.
What are 4 complications of coarctation of the aorta?
Pts at risk for:
1. hypertension (risk of lifelong hypertension if not corrected prior to 2 years of age)
2. ruptured aorta
3. aortic aneurysm
4. stroke
What are the complications of aortic stenosis
* Left vent. hypertrophy interferes with coronary artery perfusion which may result in MI, scarring of papillary muscles of l vent.
* also risk of bacterial endocarditis, coronary insufficiency and ventricular dysfunction
What L-to-R shunt does NOT lead to cor pulmonale in children (normal pressure, high volume)?
ASD
Which L-to-R shunt can lead to cor pulmonale (inc. volume AND pressure)?
VSD
What type of VSD is common in Asians?
supracristal
Of the muscular VSD's, 80% close by 1 yr of age if less than what size?
4 mm
What L-R shunt is common in premature infants?
PDA (give indomethacin)
What are 3 things done to repair TOF?
close VSD
resection of infundibulum (below pulmonary valve)
widen pulmonary valve
What 3 things can be done for Tricuspid Atresia?
NOT repairable, but to palliate:
1. Blalock-Taussig shunt (around birth)
2. glenn shunt (6-12 months)
3. fontan completion (18-36 months)
What is the standard of care for PS?
balloon valvuloplasty
What pitch is a small muscular VSD or aortic insufficiency murmur?
high pitch
What defect produces a classically holosystolic murmur during systole?
VSD... also have diastolic mitral inflow rumble if large defect
What defect produces a click (in systole) present at the left mid and upper sternal borders?
Pulmonary stenosis
Compare murmurs of PS and TOF in terms of degree of stenosis.
PS: greater stenosis= louder murmur
TOF: great stenosis = softer murmur
Mixed defects
Transposition of the great vessesl
Trunctus arteriousus
Hypoplastic left heart syndrome
True or False.
There is no murmur with hypoplastic left heart.
TRu
True or False.
Pericardial effusion may present with pulsus paradoxus.
TRu
What cardiac anomaly is associated with maternal prenatal lithium?
Epstein anomaly.
What cardiac anomaly is associated with alcohol?
asd/vsd
Harsh Pansystolic or continuous crescendo murmur. What is this?
pda
Shone's complex
supramitral valve ring
prachute mitral valve
subaortic stenosis
coarc ao
what is most associated w/turner's syndrome?
preductal co-arc ao
Pulomonary vein stenosis is associated with
R-L PFO/ASD, VSD, PDA shunt
how are the vessels positioned in L-TGA?
the aorta is anterior and LEFT of PA
what is the situs of L-TGA?
atrioventricular and ventriculoarterial discordance
How are the coronary arteries like in L-TGA?
due to discordance, they are the mirror image of a normal heart
assoications of L-TGA?
usually membranous VSD, TR, subval/val PS, pulmonary atresia,
which is the true chamber in cor-triatriatum?
dital chamber with la appendage and fossa ovalis
which is the accessory chamber in cor-triatriatum?
usually receives all 4 PV
what is associated with in cor-triatriatum?
PFO, ASD(communiates w/prox/distal chamber), TAPVR, PAPVR, Coarc, VSD, TOF, PS
what are the secondary signs similar toin cor-triatriatum?
MS ( RVH, PHTN)
what is double chambered RV divided by?
muscular band (moderator band?) that divides. Prox high pressure chamber and distal low pressure chamber
what is type A IAA?
distal to LSA
what is type B IAA?
bw LSA/LCC =MOST COMMON
-LCC is prominet and points cephald, like a pointing index finger
what is type C IAA?
prox to LCC =RARE
what is IAA ass. w/?
malalignment VSD, bicuspid Ao Valve,

-Interrupted aortic arch usually occurs with other cardiac anomalies, such as ventricular septal defects, patent ductus arteriosus, transposition of the great arteries, aortic stenosis, truncus arteriosus, bicuspid aortic valve, and atrioventricular canal defects.
what is DiGeorge syndrome ass w? Iaa wise
type b
what is the ductus like in IAA?
dilated and usually left sided
what is the CD velocity like in descending ao if PDA is large?
total absence of high vel jets
what is the CD velocity like in descending ao if PDA is restricted?
high vel jet
what are 4 types of LV inflow obstructions?
MV dysplasia/atresia
mitral arcade
parachute MV
Supramitral valve ring
what is the LV like in MS?
severe hypoplasia of LV
LVOT obstruction is associated with:
1-aortic stenosis
2-subvalv as
3-supv as
4-d-trans, double outlet RV
1-sudden death
2-status post atrioventricular canal, VSD
3-HLHS
4-The conus can form stenosis in complex lesions
is calcification of ao v commonly seen in peds?
no
what is the most common subv as?
discrete: fixed fibrous diaphragm located immediately beneath AV. It is ass. w/ aoarc, VSD.
supra as is ass w/
williams syndrome
discrete supravalvular AS
fixed fibrous diaphragm immediately above av
hourglass supravalvular AS
narrowing at sinotubular junction
tubular/diffuse supravalvular AS
uniform narrowing of asc. ao
in supravalvular AS, obstruction of CA can occur at
ostium of CA
what is the most common extracardiac shunt?
PDA
PDA closes by
2-3 wks
if pda is narrow(obstructive) the RV is ____, if PDA is wide (hypertensive), RA is
normal, RVH
in PDA, the volume load is on
LV which may fail and cause pulmonary congenstion
history of PDA
maternal rubella, prematuirty
largest ductal lenght should be
13mm
what is the flow like in ao and arteries
diastolic flow reversal. M shaped. seen in brachial, carotid, cranial, subclavian and femoral a.
types of peripheral PS
I,II, III, IV
I-MPA or RPA or LPA (single)
II- MPA extending to both branches
III- Multiple PS
IV- Central plus peripheral stenosis
PS is ass w
PFO, ASD, maternal rubella, noonan syndrome, williams syndrome
normal pul valve area is
>2.0
what CHD is most associated w/ chromosomal syndromes?
VSD trisomy 13 18 21
which vsd is most common in TOF, truncus arteriousus?
Malalignment
large, unrestrictive vsd size is
> 1.0 cm2, > 100% of ao orfice
perimembranous vsd is ass w
ventricular septal aneurysm (tricuspid pouch)