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)
|