15.2.1.2 Acyanotic Flashcards
Classification of congenital heart disease
- cyanotic heart disease
- non cyanotic disease (L to R shunts; other)
Epidemiology of congenital heart disease
- 1/100 people have it
- 3rd is critical
- 15.8 million people have congenital heart disease
Causes of congenital heart disease
- Idiopathic (mostly)
- genetic (down syndrome, trisomy 13+18; copy variant of chromosome 22) - 40%
- environmental factors of the mother while pregnant (air pollution, substance abuse {father}, rubella, diabetes)
What is a shunt?
O2 blood going to deoxygenated chamber and visa versa
Divided into:
- pre tricuspid shunt (volume load but not pressure load)
- post tricuspid shunt (volume load and pressure load)
Pre tricuspid shunts
- secundum ASD
- Primum ASD
- sinus venous defects
Big shunt but increase in PA pressures not high
Post tricuspid shunt
- VSD family
- AVSD
- PDA
Big shunt and increase in PA pressures with size of defect
Atrial septal defect
- in secundum septum
- can be small or large
- RA + RV enlargement
- RV pressure goes up a little (30 {normal = 20})
- pt don’t develop pulmonary complications
Ventricular septal defect
- LA + LV enlargement
- Pulmonary vascular resistance
- vessel wall hypertrophy downstream
- various position
Signs and symptoms: only 4-6 weeks after birth
- difficulties feeding ➡️ failure to thrive
- increased pulmonary blood flow ➡️ wheeze + chest infections
Late VSD
- pulmonary vascular resistance goes up
- cyanosis
- RV hypertrophy
Patent arterial duct
- ## result in damage to the lungs
AVSD
- Atria ventricular septal defect
- combination of shunt + leaky valves
- very common in down syndrome
Primum ASD
…
Coarctation
- arch of aorta is narrow
- present with shock (neonate)
- neonate emergency
Congenital aortic atresia
Whole aorta don’t develop
Aortic stenosis
- congenital bicuspid aortic valve
- congenital aortic valvular stenosis
Pulmonary valve stenosis
…
