Cardiology Flashcards by Anonymous 1

Most common type of TAPVR

supra cardiac

PV enters into vertical vein, azygous, or SVC

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Most common cause of complete vascular ring

DOUBLE aortic arch (40%)

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Embryonic cause of double aortic arch

right and left 4th branchial arches

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Causes of complete vascular ring

Double aortic arch (40%)
Right aortic arch + PDA/ligementum arteriosus (30%)
Aberrant right subclavian artery (20%)
Anomalous innominate artery (10%)
(rare - aberrant left pulmonary artery)

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NO synthesase converts ____ into NO in the _______

Nitric oxide synthase coverts L-ARGININE into nitric oxide in the ENDOTHELIAL CELLS lining the pulmonary blood vessels

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Nitric oxide diffuses into ______activates ________, leading to _______ production

Nitric oxide diffuses
into PULMONARY VASCULAR SMOOTH MUSCLE,
activates GUANYL CYCLASE,
leading to cGMP production

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Mediators of ductal CONSTRICTION

oxygen
prostaglandin F2
acetylcholine
bradykinin

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Mediators of ductal DILATION

PGE -1
PGE - 2
hypoxia
acidosis

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Timeline of ductal closure (functional and anatomic)

Term:
functional 48 hrs
anatomic 2-4 wks

Preterm: functional- days to weeks

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Reverse differential cyanosis causes

D-TGA + PDA + (one of the following):
- PPHN
- coarctation
- interrupted AA

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Most common type of VSD

Perimembranous VSD(70%) can extend into:

trabecular region (most common)
inlet (eg AV canal)
Infudibular region (eg ToF)

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Fetal oxygen saturation in the Umbilical vein

*70% - Umbilical Vein
65% - LEFT Atrium, LEFT Ventricle (UV +PV)
65% - PRE-Ductal (to head/upper body)
———
40% SVC (lowest coming from brain)
45% IVC
55% RIGHT Atrium, RIGHT Ventricle
55% Pulm artery, Pulm Vein
60% POST-Ductal (to lower body/placenta)

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Fetal oxygen saturation LA/LV

70% - Umbilical Vein
*65% - LEFT Atrium, LEFT Ventricle (UV +PV)
65% - PRE-Ductal (to head/upper body)
———
40% SVC (lowest coming from brain)
45% IVC
55% RIGHT Atrium, RIGHT Ventricle
55% Pulm artery, Pulm Vein
60% POST-Ductal (to lower body/placenta)

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Fetal oxygen saturation to head/upper body

70% - Umbilical Vein
65% - LEFT Atrium, LEFT Ventricle (UV +PV)
*65% - PRE-Ductal (to head/upper body)
———
40% SVC (lowest coming from brain)
45% IVC
55% RIGHT Atrium, RIGHT Ventricle
55% Pulm artery, Pulm Vein
60% POST-Ductal (to lower body/placenta)

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Fetal oxygen saturation in IVC and SVC

70% - Umbilical Vein
65% - LEFT Atrium, LEFT Ventricle (UV +PV)
65% - PRE-Ductal (to head/upper body)
———
*40% SVC (lowest coming from brain)
*45% IVC
55% RIGHT Atrium, RIGHT Ventricle
55% Pulm artery, Pulm Vein
60% POST-Ductal (to lower body/placenta)

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Fetal oxygen saturation in RA/RV

70% - Umbilical Vein
65% - LEFT Atrium, LEFT Ventricle (UV +PV)
65% - PRE-Ductal (to head/upper body)
———
40% SVC (lowest coming from brain)
45% IVC
*55% RIGHT Atrium, RIGHT Ventricle
55% Pulm artery, Pulm Vein
60% POST-Ductal (to lower body/placenta)

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Blood flow to lungs
2nd trimester
3rd trimester
>38 weeks gestation

2T - 7-15%
3T - ~35% (pulmonary vessel growth)
>38w - 20% (pulmonary vessels become sensitive to hyperemic environment and constrict)

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Percentage of fetal blood flow to the placenta

45%

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Percentage of fetal blood flow that crosses the PDA

60%

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Percentage of total fetal blood flow from RV and LV

RV - 66%
LV - 34%

Head/upper body ~20%
Lower body ~70%

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Fetal blood flow to coronaries (%)

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First degree heart block a/w :

(PR interval prolonged 2/2 delay in AV node)

myocarditis
digoxin toxicity
hypERkalemia
hypOthyroid
congenital heart disease

(tx not usually needed)

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Two equations for Cardiac Output

CO = HR x Stroke Volume

CO = Systemic BP / Total PVR

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Most common type of cardiac lesion in Tri21

Study These Flashcards

endocardial cushion defect

ECG - superior axis deviation (this lesion causes superior displacement of the AV node)

Most common cause of hypertrophic cardiomyopathy

Noonan syndrome

High lying UAC have fewer clinically obvious _______ than low lying UACs

fewer clinically obvious ISCHEMIC COMPLICATIONS

congenital heart block typically diagnosed at _____ gestation

16-24 wks *fewer than 1/3 of affected infants have a diagnosis of SLE

mortality rate for fetus/newborn with congenital heart block from anti-SSA/Ro and anti-SSB/La antibodies

20%

Most common cyanotic lesion to present in the first week of life

D-TGA (5-10% of all CHD)

Treatment for a-flutter (med)

digoxin

Most common congenital heart lesion

VSD

Recurrence rate for ToF in siblings of affected children

At what embryonic week do endocardial cushions come together to create the intracardiac septa

Week 8 -------- week 5 : cardiogenesis (paired heart tubes) tubes fuse and fold week 6 : heart beat week 7-8: septation

PDA arises from what aortic arch

6th

What arises from the 6th aortic arch

PDA Proximal pulmonary arteries

Third aortic arch

carotid artery

4th aortic arch

Left: part of the aortic arch Right: right subclavian artery

Organ that aids in clearance and metabolism of prostaglandins

Lungs - but only after pulmonary blood flow is increased after birth

TTTS - cardiac defects are are more prevalent in the _______ twin - ______ fold increase in frequency of congenital heart defects - most frequent defects are ______

- more prevalent in RECIPIENT twin - 3 fold increase - VSD, ASD, Pulm stenosis

Effect of treating hypotension w/ fluid bolus in preterm neonates

transient increase in BP (2-4 mmHg) when compared with placebo, IVF bolus showed NO DIFFERENCE in BP or mortality *majority of hypotensive preterm infants are euvolemic

Extracardiac anomalies present _____% of the time w/ Truncus

20-40% (a/w 22q11)

Normal neonatal ECG findings (that would be abnormal in adult)

(elevated right-sided forces as pulm pressures dropping) QRS axis deviated to the right upright T waves in V1 (right ventricular strain) small QRS voltages in limb leads small T wave voltages

Tall peaked P waves in neonates

Abnormal --> Right atrial enlargement

Cri du Chat chromosome

5th - partial deletion short arm of Ch 5 - deleted portion is paternal 80% of de novo events

Cri du chat cardiac

30% VSD PDA ToF

thumb hypoplasia colobomas microcephaly high nasal bridge large ears short big toe

13q deletion also: CHD increased risk of retinoblastoma (bilateral) ptosis cryptorchidism, hypospadius

Greek warrior helmet (broad beaked nose, high forehead, hypertelorism, supraorbital ridge continuous with nasal bridge)

Wolf Hirshorn 4p deletions syndrome also: low set simple ear with pre auricular dimple seizure, severe cognitive deficits cardiac GU - hypospad/cryptorchidism

elfin facies upturned nose hypercalcemia SUPRAvalvular aortic stenosis

Williams "cocktail party personality"

Most common chromosomal deletion in humans

22q11.2 1 in 4000 live births AD

Rubenstein-Taybi

16p13 - encodes cAMP regulated enhancer binding protein (CREB) - sporadic *1/4 submicroscopic deletion (some point mutations) cardiac 25% brad thumbs broad first toes

MC cyanotic heart defect identified in the first week of life

D-TGA

central cyanosis occurs when deoxygenated Hgb exceeds _____ g/dL

3 (g/dL)

hypOcalcemia -> _________ QT interval

prolonged

cyanotic CHD single S2 left superior axis on ECG

Tricuspid Atresia (likely)

MC heart defect in congenital rubella

PDA (50% chance of cardiac defect)

Williams heart defect

supravalvular sub aortic stenosis

Cardiology Flashcards

(58 cards)