structural heart defects

Question 1

difference in genetic transmission for male and female

Answer 1

female - 6%
male -2%

Question 2

acyanotic causes of congenital heart disease

Answer 2

• blood has enough o2 but pumoed abnormally
• ventricular septal defects mc
  -atrial septal defect (ASD)
  -patent ductus arteriosus (PDA)
  -coarctation of the aorta
  -aortic valve stenosis

Question 3

most common cyanotic causes

Answer 3

not enough oxygen
- tetralogy of fallot
- transposition of the great arteries
- tricuspid atresia

Question 4

what are the features of tetralogy of fallot

Answer 4

1- ventricular septal defect
2- pulmonary stenosis
3-hypertrophy of Rt ventricle
4- overriding aorta

Question 5

main issue with tetralogy of fallot

Answer 5

anterior dislocation of the septum below the pulmonary outflow which causes other issues

Question 6

symptoms you may experience with atrail septal defect

Answer 6

dizziness, palpitations

Question 7

What is a ventricular septal defect

Answer 7

L to R non cyanotic shunt - risk of eissenmengers and RVH

Question 8

aetiology of VSD

Answer 8

• chromosomal disorders
  downs, edwards, patau
• comgenital infections
• post mi

Question 9

post natal presentation of vsd

Answer 9

• failure to thrive
• features of heart failure
• pan systolic murmur

Question 10

how are infants often seen in clinic with TOF

Answer 10

Knee to chest squatting position , it increases preload and afterload , imrpoves cyanosis

Question 11

what would you find on auscultation for ventricular septal defect

Answer 11

HARSH SYSTOLIC MURMUR
VERY LOUD

Question 12

investigation for ventricular septal defect

Answer 12

echocardiogram
ECG

Question 13

PHYSIOLOGY OF VSD

Answer 13

high pressure in LV
low pressure in RV
blood flows from high pressure chamber to low pressure chamber
thus not oxygenated

Question 14

presentation of large VSD

Answer 14

• EXERCISE INTOLERANCE
  Breathless, poor feeding, failure to thrive
  Require fixing in infancy (PA band, complete repair)
  May lead to Eisenmengers syndrome

Question 15

Presentation of small vsd

Answer 15

Small increase in pulmonary blood flow only
Asymptomatic

Question 16

Treatment for small VSD

Answer 16

spontaneous
surgical closure

Question 17

treatment for large vsd

Answer 17

• nutritional support
• medication for HF
• surgical closure of the heart

Question 18

physiology of eissenmengers syndrome

Answer 18

when shunting through septal defect is from right to left
resulting in deoxygenated blood in the circulation

Question 19

2 methods to close VSD

Answer 19

surgical
percutaneous

Question 20

Summary of AVSD

Answer 20

HOLE in the centre of the heart
Massively associated with downs syndrome
- dyspnoea, exercise intolerance , eventually eissemengers , hard to treat

Question 21

summary of patent ductus arteriousus

Answer 21

ductus arterious fails to close past birth

blood shunts from aorta to pul trunk – risk of pulmonary htn

prostoglandin inhibitor may induce closure , otherwise consider surgery

Question 22

clinical signs of of patent ductus arterious

Answer 22

• continious ‘ machinery’ murmur
  If large, big heart, breathless

Question 23

Coarctation – clinical signs?

Answer 23

Right arm hypertension
Bruits (buzzes) over the scapulae and back from collateral vessels
Murmur

Question 24

what is pulmonary stenosis

Answer 24

narrowing of the outflow of the right V