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Cardio > Congenital Heart Diseases > Flashcards

Congenital Heart Diseases Flashcards

1
Q

what is the most common congenital heart disease

A

biscupid aortic valve

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2
Q

what can you develop from bicuspid aortic valve

A

aortic stenosis +- aortic regurg predisposing to IE/SBE +- aortic dilatation/dissection

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3
Q

what may accelerate complications in biscuspid aortic valve

A

intense exercise

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4
Q

can bicuspid valves go undetected at birth

A

yes, can work well at birth

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5
Q

what is atrial septal defect

A

a hole connects the atria

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6
Q

what are the most common defects for ASD

A

ostium secundum- high in the septum

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7
Q

what defects are associated with AV abnomalies (ASD)

A

ostium primum (opposing endocardial cushions- where the atrial and ventricular septi meet, and the mitral and ventricular valves meet)

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8
Q

which defect presents early out of ostium primum and secundum

A

primum presents early, secundum can be asymptomatic until adulthood. L-R shunt depends on compliance R and L ventricles. left ventricle decr with age

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9
Q

associated symptoms with ASD

A

pulm hypertension, cyanosis, arrhythmia, haemoptysis, chest pain

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10
Q

signs ASD

A

incr JVP, AF, split S2, pulm ejection systolic murmur. pulm or tricusp regurg from pulm hypertension.

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11
Q

complications ASD

A

reversal L-R shunt- Eisenmengers complex- pulm hypertension reverses the shunt leading to cyanosis. paradoxical emboli- vein-artery via ASD rare

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12
Q

ECG for ASD ostium primum

A

RBBB with left axis deviaton and prolonged PR interval.

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13
Q

how is left axis deviation diagnosed on ECG

A

+ve on lead I and aVL. -ve on lead II and aVF.

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14
Q

how is right axis deviation diagnosed on ECG

A

+ve on leads III and aVF. -ve on leads I and aVL.

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15
Q

ECG for ASD secundum

A

RBBB with right axis deviation

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16
Q

what is the treatment for ASD

A

in children closure recommended before 10 years old. in adults if symptomatic or if pulm to systemic blood flow ratios >1.5:1. transcatheter closure more common than surgery now

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17
Q

which is more common atrial or ventricular septal defect

A

atrial

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18
Q

what is ventricular septal defect

A

hole connects ventricles

19
Q

causes of VSD

A

congenital, acquired- post MI

20
Q

symptoms of VSD

A

severe heart failure in infancy, or asymptomatic and detected incidentally in later life

21
Q

signs of VSD

A

smaller holes give louder murmurs. harsh pansystolic murmur, systolic thrill +- left parasternal heave. larger holes associated with signs pulmonary hypertension

22
Q

complications VSD

A

AR, infundibular stenosis, IE/SBE (subacute bacterial endocarditis, pulmonary hypertension, Eisenmengers complex

23
Q

what is the ECG like in small VSD

A

normal

24
Q

ECG in moderate VSD

A

LAD + LVH

25
Q

ECG in large VSD

A

LVH + RVH

26
Q

what is the CXR like in large VSD

A

cardiomegaly, large pulmonary arteries, marked pulmonary plethora (enlargement of the pulmonary arteries)

27
Q

treatment of VSD

A

medical at first as may close spontaneously. indications for surgical closure- failed medical therapy, symptomatic VSD, shunt >3:1, SBE/IE. endovascular closure possible

28
Q

what is coarctation of the aorta

A

congenital narrowing of descending aorta, usually just distal to origin of left subclavian artery.

29
Q

is coarctation of aorta more common in boys or girls

A

boys

30
Q

associations of aortic coarctation

A

bicuspid aortic valve, Turners syndrome (in females)

31
Q

signs of aortic coarcation

A

radiofemoral delay (fem later), weak femoral pulse, incr BP, scapular bruit, systolic murmur

32
Q

complications aortic coarctation

A

heart failure, infective endocarditis

33
Q

tests for coarctation

A

CXR shows rib notching

34
Q

treatment of coarctation

A

surgery, balloon dilatation +- stenting

35
Q

pulmonary stenosis can occur when

A

alone or with other lesions

36
Q

what is Fallots tetralogy

A
  1. VSD. 2. pulmonary stenosis. 3. RVH. 4. aorta overriding VSD
37
Q

what is the most common cyanotic congenital heart disorder

A

tetralogy of fallot

38
Q

occasionally there can be a pentad of Fallot what is the additional condition

A

ASD

39
Q

presentation of Fallots tetralogy children

A

depends on degree of pulmonary stenosis.when hypoxic toddler may become restless agitated cry. may squat- increases peripheral vascular resistance decreases degree R to L shunt. failure to thrive clubbing

40
Q

presentation fallots adults

A

often asymptomatic. cyanosis common. late symptoms- dyspnoea, palps, RV failure, syncope, sudden death

41
Q

what does ECG show with fallots

A

RVH and RBBB

42
Q

what is the classic hallmark of fallots on CXR

A

classic boot shaped heart

43
Q

management fallots

A

give O2. child in knee chest position. morphine for sedation, long term B blockers, endocarditis prophylaxis, surgery

Cardio (15 decks)

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