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26 Cards in this Set
- Front
- Back
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When does cardiac embryogenesis begin |
3rd week of gestation |
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When does fetal heart circulation begin |
8th week of gestation |
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In fetal circulation, where does oxygenation of blood take place |
Placenta |
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Closure of ductus arteriosus |
Functional closure is usually complete within 10-15 hours of birth Anatomical closure occurs within 3 days of life |
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Closure of foramen ovale |
Functional closure by 3 months of life |
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Incidence of congenital heart disease |
8-10 per 1000 live births in developed countries |
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Etiology |
Multifactorial 1. Genetic factor: down syndrome 2. Drugs: folic acid antagonists, alcohol, warfarin 3. Viruses: rubella 4. Diabetic mothers 5. Environmental factors: esp exposure to radiation |
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Classification of CHD |
1. Cyanotic CHD 2. Acyanotic CHD |
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Acyanotic CHD |
A. Shunt defects •ventricular septal defect •patent ductus arteriosus •atrial septal defect •atrioventricular canal defect B. Obstructive defects •isolated pulmonary stenosis •isolated aortic stenosis •coarctation of the aorta |
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Cyanotic CHD |
•Tetralogy of Fallot •Transposition of the great arteries •Isolated tricuspid atresia •single ventricle with pulmonary stenosis •truncus arteriosus •double outlet right ventricle •isolated pulmonary artresia |
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Commonest cyanotic cardiac defect beyond neonatal period |
TOF |
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Features of TOF |
1. Pulmonary stenosis 2. Ventricular septal defect 3. Overriding aorta 4. Right ventricular hypertrophy |
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Clinical manifestations of TOF |
•central cyanosis •delayed tooth eruption •digital clubbing by 1-2 years •dyspnoea on exertion •squating, sitting or lying down after playing for a while •paroxysmal dyspnoeic attack (hypercyanotic spell): if severe - hemiparesis, coma, seizures, metabolic acidosis • |
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Diagnosis of TOF |
•chest x-ray: boot shaped heart with hollow pulmonary bay •echocardiography •ECG •cardiac catheterization •angiogram |
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Management of TOF |
1. Keep the patient in knee chest position 2. Give oxygen 3. Administer bicarbonate in case of metabolic acidosis 4. Morphine injection 5. Propranolol injection 6. Surgery is the mainstay: a) palliative surgery: shunt creation (aortopulmonary shunt) b) total repair surgery |
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Complications of TOF |
1. Cerebral thrombosis due to polycythemia secondary to hypoxia 2. Bacterial endocarditis 3. Bleeding tendencies 4. Congestive cardiac failure |
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Most common congenital cardiac defect |
Isolated VSD |
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Incidence of VSD |
Accounts for 20-40% of all cardiac defects and occurs equally in both male and female. 80% of VSD is located at the membranous septum |
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Type of murmur in VSD |
Pansystolic murmur |
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Complications of VSD |
Heart failure Infective endocarditis |
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Management of VSD |
•assurance of the mother because of history of closure of defect and reduced size by 5 years •give penicillin prophylaxis for infective endocarditis •give antibiotics before any dental procedure •surgical closure is done for large defects |
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Aetiological factors in patent ductus arteriosus |
Prematurity Maternal rubella Perinatal asphyxia |
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Commonest congenital cardiac defect in preterm in the neonatal period |
Patent ductus arteriosus |
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Pulse in PDA |
Bounding and collapsing |
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Type of murmur heard in PDA |
Continuous machinery murmur |
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Management of PDA |
Can be treated medically with indomethacin Surgical treatment will be needed in all PDA |
