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Cardiology > CABS Cardiac Malformations and Pericarditis > Flashcards

CABS Cardiac Malformations and Pericarditis Flashcards

1
Q

Ductus Arteriosus connects

A

the aorta with the pulmonary artery, further shunting blood away from the lungs and into the aorta

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2
Q

Fetal Development: Most of the RV output gets into systemic circulation via the

A

ductus arteriosus

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3
Q

After birth - Increased O2 leads to decreased _______ which leads to ductal _________

A

prostaglandins
closure

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4
Q

When premature and prostaglandins are too high you can give _______ to promote closure of the ductus arteriosus

A

anti inflammatories - indomethacin usually

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5
Q

What is a patent ductus arteriosus

A

when the connection between the aorta and the pulmonary artery remains open

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6
Q

What will happen to the pressures if there is a patent ductus arteriosus?

A

increased blood to the lungs - pulm edema
increased pressure on RV - right side will dilate

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7
Q

Increased risk of Patent Ductus Arteriosus with maternal ______

A

rubella

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8
Q

Fetal Development: Cardiac septation is when

A

the atria and ventricles divide into 2

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9
Q

Fetal Development: Heart begins to develop around _______ gestation

A

3 wks

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10
Q

Fetal Development: Heart begins to beat around

A

day 28

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11
Q

Atrial septal defect is when

A

there is a piece of missing tissue in the septum that separates the R and L artium

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12
Q

Atrial septal defects allow for

A

blood flow coming from LA into the RA –> leads to increased filling of the right side - dilated RA

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13
Q

3 types of Atrial septal defects

A

(m/c) ostium secundum
ostium primum
sinus venosus

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14
Q

_______ may be associated with cardiac malformations - m/c ASD

A

down syndrome

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15
Q

Patent foramen ovale is not considered an atrial septal defect because

A

there is no missing tissue

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16
Q

There should not be shunting under normal conditions with a Patent foramen ovale because

A

the LA pressure should be > than RA pressure (so the PFO will be kept shut)

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17
Q

Foramen Ovale typically closes in

A

the first week of life

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18
Q

What study can be done to test for PFO shunting

A

bubble study (can see R -> L shunting)

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19
Q

If you have a DVT with a PFO what can it lead to

A

stroke

20
Q

If you have a DVT and then have a stroke you should consider

A

PFO and getting a bubble study

21
Q

Ventricular septal defects allow for

A

Inappropriate passing of blood across the ventricular septum (m/c L -> R shunting)

22
Q

Fetal Development: Ventricular septal defects are common at

A

birth and typically spontaneously close

23
Q

Ventricular septal defects are most common in what area

A

perimembranous area of the septum typically below the LVOF

24
Q

Findings when a ventricular septal defect is present

A

enlarged/ misshapen heart
atrial dilation
Pulm edema (vascular markings/ vascular congestion)

25
Q

Tetralogy of fallot is hallmarked by

A

large ventricular septal defect
pulmonary stenosis
overriding aorta that straddles VSD
RV hypertrophy

26
Q

Most common congenital cause of cyanotic neonates is

A

Tetralogy of fallot

27
Q

Two syndromes that carries increased risk are

A

DiGeorge syndrome
Down syndrome

28
Q

In tetralogy of fallot what is happening with the blood flow

A

Large amount of deoxygenated blood is flowing from the RV into the aortic outflow tract leading to cyanosis

29
Q

Tet spells (hypercyanotic spells) occur when

A

there is an increased obstruction of the RV outflow tract (increasing intrathoracic pressure)

when kids are upset (crying), agitated, feeding, straining

30
Q

Tetralogy of flow presentation in adults

A

increased erythrocyte mass (compensating for hypoxia)
clubbing
central cyanosis
arrhythmia
arthropathy

31
Q

Coarctation of the aorta is

A

narrowing of the aorta, typically distal to the subclavian artery near the ductus arteriosus (has a pinched look)

32
Q

Coarctation of the aorta leads to

A

increased pressure proximal to the lesion and hypotension distal to the lesion

33
Q

ABI =

A

ankle brachial index

34
Q

what will the BP in the arms be compared to the BP in the ankles in coarctation of aorta

A

BP in the arms will be higher than the BP in the ankles

35
Q

Coarctation of the aorta is genetically associated with

A

tuner syndrome (typically have webbed neck and broad chest - is a partial or complete loss of chromosome x)

36
Q

On x-ray you can see what looks like a _______ in coarctation of the aorta

A

number 3

37
Q

Coarctation of aorta: pts are at risk for

A

HF
Hypertensive encephalopathy
Aortic dissection
rupture (dilated cardiomyopathy)

38
Q

Pericardium is

A

fluid filled structure that encases the heart
lubricated to reduce friction as heart moves

39
Q

Pericarditis is an

A

inflammatory disorder involving the parietal and visceral layers of the pericardium causing inflammation and discomfort

40
Q

Parietal pleura is

A

outer fibrous later

41
Q

Visceral pleura is

A

inner serosal layer

42
Q

Between parietal and visceral layer there is typically about ______ mL of fluid

A

20-60

43
Q

Pericarditis: Dx can be made with the following

A

pericardial friction rub (scratchy sound not affected by respiration)
ECG changes (diffuse ST elevation not correlated with specific coronary)
Pericardial effusion (ECHO)

44
Q

Pericarditis presentation

A

pain typically sharp chest discomfort
not linked to exertion
will not improve with vasodilation (nitro)
worse lying down, improves leaning forward
pulsus paradoxus
may have fever, elevated inflammatory markers, elevated troponin

45
Q

What is pulsus paradoxus?

A

with inspiration they will lose their pulse
(during inspiration the negative pressure will pull blood from the venous system to increase how much filling occurs within the RV)

46
Q

Pulsus paradoxus is more severe in

A

pericarditis or tamponade

47
Q

Pericarditis/ tamponade presentation on ECG

A

low voltage (decreased QRS voltage)

Cardiology (7 decks)

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