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42 Cards in this Set
- Front
- Back
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in normal fetal anatomy, what will the ppO2 be?
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low
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what is the most important aortic arch?
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6th
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what happens to the pulmonary vascular resistance during the fetal - neonatal transition?
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it drops
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what is the drop in pulmonary resistance during the fetal-neonatal transition due to? (2)
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part mechanical (air fills the lungs)
part chemical (increased pO2 relaxes vessels) |
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what are 3 genetic associations with congenital heart defects?
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trisomy 18
trisomy 21 45, XO - turner's syndrome |
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what are 4 possible clinical findings of aortic stenosis
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decreased pulse intensity
early systolic ejection click paradoxically split S2 systolic ejection murmor |
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when does aortic stenosis present?
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can present very late in life as it progresses over 5-10 years
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what are 2 treatments for aortic stenosis?
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balloon valvuloplasty
aortic valve replacement |
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what is the difference between early and late intervention in coarctation
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when treated early, you have great outcomes
when treated late, you will have premature CV disease |
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what is the immdieate treatment for coarctation of the aorta?
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prostaglandin E1 to keep the ductus arteriosus open
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if coarctation of the aorta is severe in infancy, what will pulses look like?
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they may be okay but sats in the lower extremities will be low
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if coarctation of the aorta is mild, how will it present?
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weakness or pain in the lower extremities during adolescence
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when will pulmonic valce stenosis cause symptoms?
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usually asymptomatic unless severe or with a septal defect causing blood mixing
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what are three physical findings of pulmonic valve stenosis?
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sharp, pulmonic ejection click
split S2 low-pitched systolic ejection murmur |
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what will pulomic valve stenosis look like on EKG and why?
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tall, spliked p wave due to atrial hypertrophy
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what are the outcomes of severe pulmonic valve stenosis?
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patients may live a relatively normal life
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what are 3 possible clincal findings with atrial septal defect?
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wide, fixed-split S2
sometimes causes a murmur low pitched mid-diastolic rumble |
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what are the typical outcomes of atrial septal defect?
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excellent; very large shunts will be symptomatic, identified, and treated
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what asymptomatic patients with atrial septal defect will you treat?
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those with Qp:Qs ratio of 2:1 or greater
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when/why will a patient become cyanotic with ventricular septal defect?
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when the Rpulmon:Rsystemic pressure ration reaches 1 because this is when the shunt becomes bidirectional and patient becomes cyanotic
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if a ventricular septal defect is small, what will the patients heart sound like?
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harsh, blowing, holosystolic murmur
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if a patient with ventricular septal defect is large, what are 4 symptoms that might exist?
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dyspnea
feeding difficulties poor growth heart failure |
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when will ventricular septal defect patients get dusky and why?
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with crying because it increases the pulmonary resistance and reverses the shunt
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what will the EKG of ventricular septal defect look like?
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peaked or notched p waves
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when do you use palliatve PA banding?
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when there are multiple ventricular septal defects
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what will symptoms be similar to in a large patent ducts arteriosis?
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ventricular septal defect
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what are 4 clinical findings of patent ductus arteriosus?
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wide pulse pressures
apical impulses continuous machinery-like murmur less impressive diastolic component of high pulmonary pressures |
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what are 2 treatments for PDA?
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surgical closure
transcatheter embolization |
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what is the epstein anomoly?
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tricuspid valve is dropped into the right ventricle
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what will cyanosis in the epstein anomoly depend on?
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extend of tricuspid displacement and right ventricular outflow obstruction
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what are 3 possible findings in epstein anomaly?
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holosystolic murmur due to regurgitation
gallop cyanosis and cardiomegaly in newborns |
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how can epstein anomaly improve?
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as PVR falls and RV outflow improves
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what will patients with epstein anomaly develop?
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left ventricular cardiomyopathy
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what are 2 treatment options with epstein anomaly?
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arteriopulmonary shunt
tricuspid valve repair |
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what are 6 clincial findings of tetrology of fallot?
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heart failure from L--> R shunt
cyanosis dyspnea with exertion "tet" spells (hypercyanotic attacks) loud, harsh systolic murmur single S2 or soft P2 |
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what can tet spells cause?
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metabolic acidosis
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what are 3 treatment options for tetrology of fallot?
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prostaglandin E2 to maintain ductal flow
tet-spell aversion/management surgical palliation |
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what are 6 clinical presentations of transposition of the great arteries
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cyanosis
severe hypoxemia worsens as ductal arteriosus closes EKG is normal CXR shows egg shaped heart soft murmur |
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what heart defect can be fatal in the neonatal period if not treated?
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transposition of the great arteries
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why is transposition of the great arteries fatal without treatment?
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if the foramen ovale and ductus closes completely, there is no oxygenation of systemic blood
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what are three treatment options for transposition of the great arteries?
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prostaglandin E1
atrial septostomy arterial switch |
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five Ts and H of cyanotic congenital heart disease
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Tetrology of fallot
transposition of the great arteries truncus arteriosus tricuspid atresia total anamalous pulmonary venous return hypoplastic left heart |
