Flashcards in 2 - Paeds - CVS - Transposition of the Great Arteries Deck (9):
What happens? blood flows? how is this compatible with life?
aorta and pulmonary artery are switched
RV > Aorta
LV > PA
blue blood >body
pink blood > lungs
2 parallel circulation only comp with life if mixing -> VSD, ASD, PDA - other anomalies
Sx + presentation
cyanosis, may be profound/fatal
usually present when duct closes (day 2) -> less mixing
Cyanosis less severe/present later if assoc. anomalies eg ASD
loud single HS2
usually no murmur unless inc flow/stenosis in left outflow (systolic)
Ix - CXR?
CXR - narrow upper mediastinum with 'egg on side' appearance of cardiac shadow, marked pulm vasc due to inc pulm bf
Ix ECG + ECHO
Echo shows anatomy
MGMT - if sick/cyanosed neonate? how to allow mixing if no communication?
improve mixing - prostaglandin - maintain DA patency
balloon atrial septostomy (life saving, 20% cases) to open foramen ovale
MGMT - all pts need?? what is done and when?
neonatal period - arterial switch - coronary arteries transferred to new aorta
Eisenmenger syndrome - what is it
chronic untreated high pulm bf due t L->R shunt/common mixing, causes pulm arteries to become thick walled and more resistant
Shunt decreases - reduces Sx - until 10-15y, shunt reverses -> blue teenager = eisenmenger