B4-048 CBCL Congenital Heart Defects Flashcards
(87 cards)
1
Q
if the abnormal O2 is first observed in the right ventricle, what is the defect?
A
VSD
2
Q
if the abnormal O2 is first observed in the right atrium, where is the defect?
A
ASD
3
Q
if the abnormal O2 is first observed in the pulmonary artery, what is the defect?
A
ductus arteriosus
4
Q
in the absence of a cardiac shunt, cardiac output is equal to
A
pulmonary blood flow
5
Q
in the presence of a cardiac shunt, the magnitude of the shunt is equal to
A
the difference between CO and pulmonary blood flow
6
Q
calculation for cardiac output
A
7
Q
septum between right and left atrium doesn’t close after birth
A
ASD
8
Q
90% of ASD cases are due to a defect in
A
ostium secundum
9
Q
comonly associated with fetal alcohol syndrome
4
A
- ASD
- VSD
- PDA
- TOF
10
Q
10% of ASD is due to a defect in
also associated with 25% of down syndrome cases
A
ostium primum
11
Q
acyanotic
A
left to right shunt
12
Q
what type of shunt is ASD?
A
left to right
13
Q
increased O2 sat in
* right atrium
* right ventricle
* pulmonary artery
A
ASD
14
Q
splitting S2 due to delayed pulmonic valve closure
may also have systolic murmur
A
ASD
15
Q
- embolism starts in right side but cross to left side of heart via defect
- can enter systemic circulation and cause stroke
A
paradoxical embolism
16
Q
treatment: ASD
specify child vs. adult
A
- child: monitor, may close on own
- adult: surgery, patch opening
17
Q
infant cases appear after the aortic arch but before the patent ductus arteriosus
A
coarctation of the aorta
18
Q
- lower extremity cyanosis, weak pulses
- hypertension in upper extremities
A
coarctation of the aorta
19
Q
increased risk of HF, cerebral hemorrhage, aortic rupture, and endocarditis
A
coarctation of the aorta
20
Q
becomes ligamentum arteriosum
A
ductus arteriosus
21
Q
keeps ductus arteriosus open
A
prostaglandin E2
22
Q
associated with congenital rubella syndrome
3
A
- PDA
- ASD
- VSD
23
Q
what kind of shunt is PDA?
A
left to right
24
Q
continous, machine like murmur
A
PDA
25
uncorrected left to right shunt increases the pulmonary blood flow causing pulmonary arterial hypertension
eisenmenger syndrome
26
causes late cyanosis, clubbing, and polycythemia
| associated with L to R shunt
eisenmenger syndrome
27
closes PDA, and inhibits PGE2
indomethacin
28
four abnormalities of TOF
1. **p**ulmonary stenosis
2. **R**VH
3. **o**verriding aorta
4. **V**SD
| **PROV**e
29
boot shaped heart on CXR
TOF
30
caused by anterosuperior displacement of the infundibular septum
TOF
31
what kind of shunt is TOF?
right to left
32
most common cause of cyanotic CHD
TOF
33
associated with chr 22q11
| DiGeorge
TOF
34
why does squatting (knee chest position) reduce cyanosis?
* kinks femoral artery
* increases TPR
* increases pressure in LV
* Left > Right
* shunt temporarily reverses
| treat tet spell
35
crying, fever, and exercise exacerbates RV outflow obstruction
tet spell
TOF
36
what kind of shunt is TGA?
right to left
37
* aorta leaves RV
* pulmonary trunk leaves LV
| results in complete separation of systemic and pulmonary circulation
TGA
38
not compatible with life unless a shunt is present
| patent foramen ovale/PDA, or VSD
TGA
39
due to failure of the aorticopulmonary septum to spiral
TGA
40
fails to divide into pulmonary trunk and aorta due to failure of aorticopulmonary septum formation
persistent truncus arteriosus
41
what kind of shunt is PTA?
right to left
42
majority caused by defect in membranous septum
VSD
43
holosystolic murmur at lower left sternal border
VSD
44
larger VSDs can cause
| 3
* pulmonary hypertension
* HF
* Eisenmenger's syndrome
45
associated with maternal diabetes in pregnancy
| 3
* TGA
* PTA
* VSD
46
pansystolic murmur noted after the first month of life
VSD
47
blood O2 content greater in right ventricle than in the right atrium
| indicates...
left to right shunt [VSD]
48
the magnitude of the shunt is equal to
cardiac output - pulmonary blood flow
49
complications of ASDs
| 4
* cyanosis
* RVH
* righ HF
* paradoxical emboli
50
what additional defect is associated with TGA?
ventricular septal defect
51
* machine-like murmur best heard at the left suprasternal notch
* cyanosis of toes but not fingers
patent ductus arteriosus
52
hypertension in upper extremities and hypotension in legs
coarctation of the aorta
53
the clinical outcome of TOF is dependent on
severity of stenosis
54
O2 content in pulmonary artery greater than the RV
PDA
55
O2 content in RV greater than RA
VSD
56
* present about 6 weeks of life
* tachypnea
* poor feeding
* growth retardation
* sweating
atrioventricular canal defect
57
up to 40% of individuals with Down syndrome have [...] defects
atrioventricular canal
58
elevated upper extremity blood pressure and reduced lower extremity blood pressure
coarctation of the aorta
59
machine like murmur
cyanosis of toes
PDA
60
if the patient has a regular rhythm, heart rate can be calculated from EKG by
counting R-R intervals
divide from 300
61
in left axis deviation, the QRS complex will have a positive net deflection in [...] and a negative deflection in [...]
lead 1 positive
lead aVF negative
62
* positive net deflection in lead 1
* negative net deflection in lead aVF
left axis deviation
63
risk of inheritance in autosomal dominant disorder
50%
64
risk of inheritance in autosomal recessive disorder
25%
65
what promotes hypertension in coarctation of the aorta?
dimished renal blood flow triggers RAAS
66
pulse differential from upper and lower extremities
coarctation of the aorta
67
* most common type of ASD
* occurs in middle of the wall between the atria
defect in septum secundum
68
puppy break
69
ASD defect that occurs in the upper part of atrial septum
| rare
defect in sinus venosus
70
ASD defect occurs in part of the wall between the coronary sinus and left atrium is missing
defect in coronary sinus
71
cyanosis of the lower extremities but not the upper body
differential cyanosis
72
* elevated arterial pressure in arms and head arteries
* much lower arterial pressure in lower extremities
coarctation of the aorta
73
blood O2 content in pulmonary artery greater than right ventricle
PDA
| due to shunting
74
O2 content increased in right atrium compared to systemic veins
ASD
75
* harsh continous murmur heard at left sternal border
* arterial blood oxygen content higher in right hand than left foot
PDA
76
* tachycardia
* dyspnea
* continous murmur
* cardiomegaly
* differential cyanosis
PDA
77
increased pulmonary resistance leads to reversal of shunt and corresponding cyanosis
Eisenmenger's syndrome
78
* manifests a few weeks after birth
* pansystolic/holosystolic murmur at left sternal border
* higher than expected oxygen in right ventricle
VSD
79
defects associated with TOF
| 4
* Pulmonary stenosis
* RVH
* Overriding aorta
* VSD
| PROVe
80
what causes the closure of the foramen ovale at birth?
* higher pressure in the left atrium compared to right atrium
* caused by venous return from pulmonary veins and dilation of pulmonary arterioles
81
at birth, the vascular pressure [...] and left atrial pressure [...] the right
decreases; exceeds
| forces septum primum against the secundum, closing foramen ovale
82
neural crest cells are key to the formation of
membranous IV septum
83
ejection fraction equation
EDV-ESV/EDV
84
CO equation from Fick principle
oxygen consumption/(arterial O2 content- mixed venous O2 content)
85
label the chambers of the heart on this apical view
86
use of ultrasound to define cardiac structures
echocardiography
87
in the apical 4 chamber view, the right heart is on what side of the image?
left
