Cardiology - Congenital heart defects Flashcards
(53 cards)
A group of cardiac defects characterized by left-to-right sound which causes pulmonary hypertension and RA and PV hypertrophy
acyanotic congenital heart defects
Common acyanotic congenital heart defects
- ASD
- VSD
- AVSD
- PFO
- PDA
- Coarctation of the aorta
- Pulmonary valve stenosis
Defect in the inter-atrial septum causing a left to right shunt and RA and RV volume overload
atrial septal defect (ASD)
Conditions associated with ASD
- Down syndrome
- Fetal alcohol syndrome
- TORCH infections
- Holt-Oram syndrome (hand-heart syndrome)
Auscultation findings of ASD
- mid-systolic ejection murmur
- WIDE split second heart sound (S2) over the second left intercostal space. The split does not change with respiration (fixed)
Patients with ASD are at increased risk for what complication?
- Paradoxical embolism (increased risk of ischemic stroke) - embolus from the venous circulation passes from the RA through the ASD to the LA and enters the arterial circulation to cause a stroke
- heart failure
Defect in the inter-ventricular septum causing a ventricular left to right shunt, RV and LV volume overload and pulmonary hypertension.
ventricular septal defect (VSD)
Conditions associated with VSD
- maternal diabetes
- Down syndrome
- Edward syndrome
- Patau syndrome
- TORCH infection
Auscultation findings for VSD
- harsh holosystolic murmur over the left lower sternal border
- mid-systolic murmur over the cardiac apex
- loud pulmonic S2 (pulmonary hypertension)
Variable deficiency in atrioventricular (AV) septa that can cause AV left to right shunt, AV valve regurgitation and pulmonary hypertension
atrioventricular septal defect (AVSD)
Condition associated with AVSD
Down syndrome
Persistence of the ductus arteriosus postnatally causing a left to right shunt from the aorta to the pulmonary artery
patent ductus arteriosus (PDA)
Conditions associated with PDA
- Fetal alcohol syndrome
- Congenital rubella
- Down syndrome
- prematurity
A complication of acyanotic heart disease in which the shunt direction reverses and cyanotic heart disease develops.
Eisenmenger syndrome
Findings in PDA
- Bounding peripheral pulses
- wide pulse pressure
- laterally displaced heave
- loud, continuous murmur heard best at the left infraclavicular region and loudest at S2 (machinery murmur)
Narrowing of the aortic arch causing LV outflow tract obstruction, collateral circulation, difference in blood pressures and distal systemic hypo-perfusion
Coarctation of the aorta
Conditions associated with Coarctation of the aorta
Turner syndrome
Coarctation of the aorta is often accompanied by
- bicuspid aortic valve
- VSD
- PDA
Findings in Coarctation of the aorta
- cyanosis of the lower extremities
- brachial-femoral delay (weak femoral pulses)
- increased BP in upper extremities and decreased BP in the lower extremities
- cold feet and lower extremity claudication upon physical exertion
- systolic ejection murmur over the left posterior hemithorax
Findings of Coarctation of aorta on CXR
- Figure of 3 sign
- rib notching (sign of chronic disease not usually visible before age 5)
Dilation of the aorta and left subclavian artery causing an hourglass-like narrowing of the aorta and a 3-shaped outline on CXR.
Figure of 3 sign
Collateral circulation between the internal thoracic and intercostal arteries on CXR usually in children > 5 yo
Rib notching
Narrowing at the pulmonary valve causing RV outflow tract obstruction and RV hypertrophy
Pulmonary valve stenosis
Conditions associated with pulmonary valve stenosis
Congenital rubella
