Salvucci 09-14-07 Congenital Heart Disease

Front 1

Describe the Cardiac tube at 4 weeks

Back 1

Sinuatrium (both atria), primitive ventricle (both ventricles), bulbus cordis (outflow tract portion of both ventricles), truncus arteriosis (aorta and pulmonary arteries)
Chambers in series

Front 2

In the Next 4 weeks, the cardiac tube doubles over on itself. Describe what happens

Back 2

Doupbling over of cardiac tube creates two pumps in parallel, both with 2 chambers each
Endocardial cushions develop: specialized cells responsible for the develoment of the AV canal (atrial septum primum, upper portion of the ventricular septum, the medial leaflets of the mitral and tricuspid valves)

Front 3

the prototype of endocardial defects

Back 3

Trisomy 21

Front 4

Various fetal environmental issues can result in hypertrophy of the opposite wall of the aorta from the PDA and result in WHAT?

Back 4

coarctaion of the aorta

Front 5

Rubella can cause what congenital defects?

Back 5

PDA, PS, ASD

Front 6

Lithium can cause what congenital HD?

Back 6

tricuspid valve abnormalities

Front 7

Maternal Lupus can cause what CHD?

Back 7

congenital heart block

Front 8

TEST QUESTION:

ECG finding of ostium primum.

Back 8

ECG left axis deviation is hallmark

Front 9

ECG finding of ostium secundum

Back 9

Normal or rightward ECG axis

Front 10

What CHD?
Abnormality of SVC/pulmonary vein development/insertion
85% associated with anomalous pulmonary vein-SVC attachment

Back 10

Sinus Venosus ASD

Front 11

What ASD?
15-20% associated with MVP

Back 11

Secundum ASD

Front 12

What ASD?
Endocardial cushion defect

Back 12

Primum ASD

Front 13

Which ASD?
Connective tissue abnormality

Back 13

Secundum ASD

Front 14

Which ASD?
Possible association with VSD, MR, TR, heart block

Back 14

Primum ASD

Front 15

ASD has fixed splitting. What is the diff b/w fixed and persistent splitting?

Back 15

Persistent splitting is associated with a block and the split still changes with respiration (?)

Front 16

What do you see in CXR of ASD?

Back 16

prominent pulm. Vasculature

Front 17

What is diagnostic tool for ASD?

Back 17

Echo

Front 18

Murmur of ASD?

Back 18

Early systolic murmur (diamond shaped), upper left sternal border (results from increased pulmonary outflow tract flow)

Front 19

Murmur of VSD?

Back 19

Classic murmur: holosystolic, mid left sternal border, possible thrill

Front 20

Symptoms of VSD?

Back 20

Small: Asymptomatic
Big: Dyspnea, chf, fatigue

Front 21

4 parts of TOF

Back 21

VSD, RV outflow obstruction, RV hypertrophy, over-riding aorta

Front 22

Murmur of PDA

Back 22

Conitnuous, machine-like murmur, upper left sternal border

Front 23

Describe the possible cyanosis pattern of Eisenmenger's PDA

Back 23

Eisenmenger’s can result in differential cyanosis (lower body only) because of location of shunt)

Front 24

Most common congenital abnormality with AS

Back 24

Bicuspid AV

Front 25

Other causes of AS symptoms

Back 25

Sub valvular membrane, sub valvular muscular hypertrophy: rare
Supra-valvular stenosis

Front 26

Murmur of AS

Back 26

Clinically, early systolic murmur, 2nd RICS

Front 27

combination of ASD with rheumatic acquired MS: anything is possible
Think of potential clinical manifestations (ASD, obstruction of MV flow magnifies left to right shunt)

Back 27

Lutenbacher’s syndrome:

Front 28

Murmur of PS

Back 28

Early systolic murmur, upper left sternal border

Front 29

Cleft MV leaflet: Which one? What's defect assoc.?

Back 29

Medial leaflet, endocardial cushion defect

Front 30

What "anomaly"?
(low insertion of the TV in the RV, associated with ASD. TR can be severe.

Back 30

Epstein's

Front 31

Murmur of coarctation of aorta

Back 31

Systolic murmur over left precordium, back

Front 32

What type of anomalous coronary artery?
Benign, most common, 1% of population
CX always takes a posterior course, no clinical issue

Back 32

CX origin from right sinus or RCA

Front 33

What type of anomalous coronary artery?
If it takes an anterior course (anterior to PA) no clinical issue
Coursing between PA and aorta can result in constriction with exertion, sudden ischemia, sudden death

Back 33

LAD from right sinus or RCA

or

LCA from right sinus or RCA

Front 34

What type of anomalous coronary artery?
Posterior course, no clinical issue
Course between PA and Aorta: exercise related sudden ischemia, sudden death

Back 34

RCA from left sinus or LCA