19 - Congenital Heart Dz 1 Flashcards

1
Q

a child with cyanotic heart dz most likely has a heart defect that shunts left>right or right>left?

A

right>left

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2
Q
which of the following pts is most likely to have irreversible pulm HTN?
10 yo w/ tetralogy of Fallot
1 yo w/ muscular VSD
10 yo w/ truncus arteriosus
10 yo w/ ASD
A

truncus arteriosus

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3
Q

presentation of a congenital heart disease mostly depends on the state of the _____

A

pulmonary circulation

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4
Q

4 factors determining consequences of shunt

A

size of defect
vascular resistance
pressure gradient
distensibility of chambers

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5
Q

3 L>R shunts

A

ASD, VSD, PDA

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6
Q

major consequences of L>R shunts and when do they tend to present in general

A

pulm edema and CHF

tend to take years to present - could be well into adulthood

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7
Q

most common ASD is in which part of septum?

A

secundum (90%)

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8
Q

primum ASD is also assoc w/

A

TV and MV malformations

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9
Q

which type of VSD is associated with multiple holes?

A

muscular

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10
Q

when does VSD tend to cause problems?

A

often much earlier - even in neonatal period

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11
Q

why do you want to repair L>R shunts earlier rather than later?

A

avoid irreversible pulm HTN - at that point repairing defect is no longer indicated

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12
Q

tetraology of fallot defects

A

RVOT stenosis
VSD
aortic override of VSD
RV hypertrophy

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13
Q

which type of VSD is associated with multiple holes?

A

muscular

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14
Q

when does VSD tend to cause problems?

A

often much earlier - even in neonatal period

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15
Q

why do you want to repair L>R shunts earlier rather than later?

A

avoid irreversible pulm HTN - at that point repairing defect is no longer indicated

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16
Q

tetraology of fallot defects

A

RVOT stenosis
VSD
aortic override of VSD
RV hypertrophy

17
Q

TV atresia - consequences and structure

A

obligate R>L atrial shunt

pulm circulation depends on size of VSD > cyanotic heart dz

18
Q

truncus arteriosus affects pulm circulation in what way?

A

pressure overload > high risk for pulm HTN

19
Q

total anomalous pulm venous connection (TAPVC) - structure and consequences

A

pulm veins dont connect to LA - usually connect to innominate vein
obligate ASD
inc pulm blood flow