Cardiac Pathology

Question 1

What are the characteristic symptoms of CoA?

Answer 1

heart murmur
high BP in arms, low BP in legs

Question 2

How does one divide cyanotic geart disease

Answer 2

decreased pumonary flow (ToF, TA, univentricular heart + pulmonary stenosis) vs increaded pulmonary flow (TGA, TAPVR)

Question 3

What are the four features of ToF?

Answer 3

ps, rvh, overriding aorta, vsd

Question 4

What is tricuspid atresia?

Answer 4

Tricuspid atresia is a lack of tricuspid valve, which causes decreased pulmonary artery flow

Question 5

What syndromes can feature AVSD

Answer 5

Down syndrome

Question 6

How can one subdivide non-cyanotic heart lesions?

Answer 6

left-to-right shunting vs.

Question 7

The most common cyanotic heart defect?

Answer 7

Tetralogy of Fallot (7-10% of all CHDs)

Question 8

What step of cardiac development in the embryo is theorized to be responsible for Tetralogy of Fallot?

Answer 8

Malalignment of upper part of conal septum

Question 9

If the pulmonary obstruction is mild in Tetralogy of Fallot, what can possibly happen in the neonate?

Answer 9

The neonate may not have immediate cyanosis.

Question 10

How can you fix a tet spell?

Answer 10

Squatting kinks the femoral artery, increases the systemic arterial pressure, building up backpressure that will reach the left ventricle, increasing left ventricular pressure, thereby temporarily reversing right-to-left shunting.

Question 11

Where is the most common site of PS?

Answer 11

infundibulum, just in front of the pulmonary valve

Question 12

How can the body compensate for pulmonary artery stenosis?

Answer 12

Multiple aorto-pulmoary collateral arteries (MAPCA) can offset pulmonary artery pressure

Question 13

How will O2 therapy help treat Tet spells

Answer 13

Cause pulmonary vasodilation and systemic vasoconstriction

Question 14

Between DTGA and LTGA, which is more common?

Answer 14

DTGA (aorta is to the right and in front of the pulmonary artery and no inversion of the ventricles) is more common.

Question 15

Why is DTGA more problematic?

Answer 15

The aorta is connected to the right ventricle, which carries deoxygenated blood, so deoxygenated blood is getting circulated throughout systemic circulation, which is incompatible with life.

Question 16

Why is a shunt necessary for the survival in TGA?

Answer 16

The venous and arterial circulations will be otherwise segregated, leading to no systemic perfusion, thereby impending

Question 17

How does one fix DTGA?

Answer 17

arterial switch - put each great vessel in its rightful vebtricle
atrial switch - a baffle, or a tunnel, is created between the atria, this isn’t done often

Question 18

In TA, what goes wrong in cardiac development?

Answer 18

neural crests don’t migrate during development of cardiac outflow tract, leaving the two great vessels connected.

Question 19

In which CHD is a patent DuA beneficial?

Answer 19

DTGA

Question 20

For which valvular diseases are rheumatic heart disease the most common etiology?

Answer 20

mitral valve stenosis, tricuspid valve stenosis

Question 21

What is Ebstein’s Anomaly?

Answer 21

When the tricuspid valve is moved towards apex more than normal

Question 22

Which 3 conditions must be satisfied for infective bacterial endocarditis to occur on the heart valve?

Answer 22

1. Valve surface must be rough, easy to adhere to
2. Bacteria involved in infection take advantage of ease of adherence to valve.
3. Some of the bacteria on the valve surface survive the initial infection, and can propagate infected vegetations

Question 23

Which cardiomyopathy type is associated with septal antefior motion (SAM)?

Answer 23

hypertrophic cardiomyopathy

Question 24

What does the degree of perixardial tamponade depend on?

Answer 24

the time elapsed during filling

Question 25

What is the most relevant complication associated with atrial arrhythmias?

Answer 25

thrombus