Acyanotic CHD

Question 1

Coarctation of Ao

…associated with?

Answer 1

Coarc = narrowing of DA (SSN CW- vel over 2.5 = ?; do PW walkdown)

sign: elevated BP in arm and weak pulse in lower extremities

associated with bicuspid

Question 2

Coarctation hemodynamics?

Answer 2

increased afterload = LVH

Question 3

Cor Triatriatum

Cor Triatriatum Sinster vs Dexter

Answer 3

A perforate membrane through the “middle” of atria

Sinster - LA, similar symptoms to MS
Dexter - RA, rare

Question 4

Ebstein’s Anomaly

Answer 4

Apical displacement of septal and/or posterior TV leaflet by at least 8 mm

• causing severe TR? Right side dil….

Question 5

ccTGA

Answer 5

ccTGA = L-TGA

fetal heart tube rotated left instead of right…. so LV and RV have switched spots

double discordance: atrioventricular and ventriculoarterial

RV/TV in systemic position but not designed for high press… TR and RV failure

Question 6

PAPVR

Answer 6

PAPVR = Partial Anomalous Pulmonary Venous Return

1 or more (but not all 4) PVs are not connected to LA
(some O2 blood goes to RA)

hemodynamics similar to ASD: Right side vol overload and dilation… PHTN?…RV hypertrophy?

Question 7

LSVC

Answer 7

Persistent Left SVC

commonly: LSVC - CS - RA
no consequences (LSVC drains into RA like its supposed to)

dilated CS?

Two SVCs in total

Question 8

How can you use a bubble study to diagnose LSVC?

Answer 8

inject agitated saline into LEFT arm

see opacification of CS 1st? = LSVC

Question 9

What conditions cause a dilated CS?

Answer 9

unroofed CS*
PAPVR*

PLSVC

*problem

Question 10

Dextrocardia scanning protocol

Answer 10

Start with SC, if dextrocardia roll patient to right side and label screen “Dextro”

PLAX - align as normal
turn to SAX (90 clockwise) *
Ap same as SAX *
*L and R flipped

SSN arch position?