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Cardiovascular - Yr1 > Congenital > Flashcards

Flashcards in Congenital Deck (25):
1

What is a congenital heart disease?

abnormality in heart structure

2

how common are congenital heart diseases?

1% of births

3

What are the demographics of congenital heart disease?

more common in males

4

how do you treat mild CHD?

as usually asymptomatic they may resolve or progress on their. no immediate tx needed

5

how do you treat moderate CHD?

requires specialist intervention and monitoring in a cardiac centre

6

how do you treat sever CHD?

as they present severely ill as a newborn they often don't survive to the point of tx

7

what makes CHD major?

if they require surgery within the 1st year of life

8

what are the 4 causes of CHD?

maternal prenatal rubella infection
maternal alcohol abuse
maternal treatment and radiation
genetic/chromosomal abnormalities

9

what are the common signs & symptoms of CHD? (6)

central cyanosis due to R-L shunting
pulmonary hypertension finger clubbing
paradoxical embolism of thrombus from systemic venous to systemic arterial system bc communication between R & L
polycythaemia secondary to chronic hypoxaemia
growth retardation
syncope

10

how do they usually present? (6) [other than screening]

endocarditis
progression of valvular lesions
A&V arrhythmias
sudden cardiac death
RHF
end stage HF

11

what are the 6 main CHDs?

VSD
ASD
PDA (patent ductus arteriosus)
Coarctation of aorta
Cyanotic congenital heart disease: fallot's tetralogy
Transposition of the great arteries (TGA)

12

what is VSD?

most common
a defect in the ventricular septum
the LV pressure is higher than the RV pressure therefore the blood moves from the left to the right and the pulmonary blood flow increases

13

what are the clinical features of a small VSD?

asymptomatic and usually close spontaneously
have a future risk of aortic regurgitation or endocarditis

14

what are the clinical features of a moderate VSD?

fatigue and dyspnoea w/ cardiac enlargement and prominent apex beat. palpable systolic thrill over tricuspid area

15

what are the clinical features of a large VSD?

pulmonary hypertension

16

what investigation are needed for VSD?

CXR - prominent pulmonary artery
echo and CW Doppler - size and location of VSD
cardiac MRI

17

what treatment are needed for VSD?

moderate/large = surgical intervention

18

what is an ASD?

an atrial septal defect
more common in women
1st diagnosed in adults

19

what are the clinical presentation of an ASD?

often RV heave
children mostly asymptomatic but prone to pulmonary infection

20

what investigations are needed for an ASD?

CXR - prominent pulmonary artery
ECG - shows RBBB or right axis deviation
echo
cardiac MRI

21

what treatment is required for an ASD?

repaired before 10y/o/
unclear whether to treat in adulthood

22

what is PDA?

patent ductus arteriosus
the DA joins the bifurcation of the pulmonary artery to the descending aorta in foetal development (distal to subclavian artery). as foetus, it directs blood away form the pulmonary system and into the system circulation (deoxygenation with placenta) after birth the high O2 levels in the lungs close the duct. however if there is malformation it wont close.

23

what are the clinical features of PDA?

often asymptomatic until later life when HF or IE develop.
CONTINUOUS MACHINERY MURMUR
peripheral pulse is bounding (large in volume) bc of increase left heart blood flow and decompression of aorta into the pulmonary artery

24

what investigations are needed of PDA?

CXR - aorta and pulmonary system prominent
ECG - LA & LV hypertrophy
echo - dilated LA &LV

25

what treatments are needed of PDA?

medically treat premature infants with indomethacin (inhibits prostaglandins and stimulates duct closure)
the duct can be ligated surgically (needed ASAP >5y/o)