Flashcards in Congenital Deck (25):
What is a congenital heart disease?
abnormality in heart structure
how common are congenital heart diseases?
1% of births
What are the demographics of congenital heart disease?
more common in males
how do you treat mild CHD?
as usually asymptomatic they may resolve or progress on their. no immediate tx needed
how do you treat moderate CHD?
requires specialist intervention and monitoring in a cardiac centre
how do you treat sever CHD?
as they present severely ill as a newborn they often don't survive to the point of tx
what makes CHD major?
if they require surgery within the 1st year of life
what are the 4 causes of CHD?
maternal prenatal rubella infection
maternal alcohol abuse
maternal treatment and radiation
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
how do they usually present? (6) [other than screening]
progression of valvular lesions
sudden cardiac death
end stage HF
what are the 6 main CHDs?
PDA (patent ductus arteriosus)
Coarctation of aorta
Cyanotic congenital heart disease: fallot's tetralogy
Transposition of the great arteries (TGA)
what is VSD?
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
what are the clinical features of a small VSD?
asymptomatic and usually close spontaneously
have a future risk of aortic regurgitation or endocarditis
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
what are the clinical features of a large VSD?
what investigation are needed for VSD?
CXR - prominent pulmonary artery
echo and CW Doppler - size and location of VSD
what treatment are needed for VSD?
moderate/large = surgical intervention
what is an ASD?
an atrial septal defect
more common in women
1st diagnosed in adults
what are the clinical presentation of an ASD?
often RV heave
children mostly asymptomatic but prone to pulmonary infection
what investigations are needed for an ASD?
CXR - prominent pulmonary artery
ECG - shows RBBB or right axis deviation
what treatment is required for an ASD?
repaired before 10y/o/
unclear whether to treat in adulthood
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.
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
what investigations are needed of PDA?
CXR - aorta and pulmonary system prominent
ECG - LA & LV hypertrophy
echo - dilated LA &LV