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Congenital Heart Disease Flashcards

1
Q

Congenital heart disease

This is a general term used to describe _______ of the _____ or ______ that are present from _____

A

abnormalities

heart or great vessels

birth

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2
Q

Congenital heart disease

• Usually arises from faulty embryogenesis during the ____ week of gestation (max ____ week)

A

3rd

5th

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3
Q

Congenital heart disease

few are associated with live birth

T/F

A

F

Most are associated with live birth

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4
Q

Congenital heart disease

some are not compartible with intrauterine survival

T/F

A

T

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5
Q

AETIOLOGY of congenital heart disease
•____% unknown

•__________ ,with genetic and environmental factors playing a part

• associated with chromosomal disorders such as ——— and ______ syndrome

A

90

Multifactorial

Downs and Turners

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6
Q

AETIOLOGY of congenital heart disease

• Infection such as _______
• Hypoxia
•__________
•_______ exposure to mother (especially between __-__ week)

A

Rubella

Thalidomide

Radiation

3-8

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7
Q

SHUNTS- These are __________ between the chambers or blood vessels;
• -left to right shunts
• -right to left shunts

A

abnormal communications

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8
Q

Initial left to right shunt
• - ____
• -_____
• __________________
• -APVD
• ______________ SYNDROME

• Right to left shunt
• -______
• -____

A

ASD; PDA

PERSISTENT TRUNCUS ARTERIOSUS (PTA)

HYPOPLASTIC LEFT HEART

TOF; TA

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9
Q

What congenital heart defect has the highest Relative Incidence

A

VSD

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10
Q

ATRIAL SEPTAL DEFECT
• ASD refers to an abnormal opening in ________ allowing communication of blood between the ________ and _______

A

atrial septum

right and left atrium

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11
Q

ATRIAL SEPTAL DEFECT is the same as a patent foramen ovale which occurs in about ___% of normal individuals

T/F

A

F

different from a patent foramen ovale

30

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12
Q

ATRIAL SEPTAL DEFECT

• There 3 main types ;

• - _______ type
• -_________ type ASD
• -___________ type

A

sceundum

primum

sinus venosus

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13
Q

ATRIAL SEPTAL DEFECT

• There 3 main types ;

• -sceundum type ,located _______
• -primum typeASD, _________
• -sinus venosus type, near the ———

A

highup

lowerdown

SA node

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14
Q

ATRIAL SEPTAL DEFECT: Secundum type ASD

•_____ % of all ASDs
• Results from defiency or fenestration of the ___________,__________, or _________

A

90

embryonic septum primum, deficiency of septum secundum or both

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15
Q

ATRIAL SEPTAL DEFECT: Secundum type ASD

• Aperture may be _____,_______, or_______

• Larger defect creates a ________

A

single, multiple or fenestrated

single atrial chamber

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16
Q

ATRIAL SEPTAL DEFECT: Primum type ASD

• ____% of all ASDs

• Occurs (low or high?) in the atrium

A

5

Low

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17
Q

ATRIAL SEPTAL DEFECT: Primum type ASD

• (Antero or Posterò?) -(inferior or superior ?) to the fossa ovalis and adjacent to the ________

A

Antero ; inferior

AV node

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18
Q

ATRIAL SEPTAL DEFECT: Primum type ASD

• associated with ___________ leaflet and can be associated with _______ defect

A

left anterior mitral

partial AV

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19
Q

ATRIAL SEPTAL DEFECT: Sinus venosus

•___% of all ASDs

• Located (low or high ?) in atrial septum, near _______ which may saddle it

A

5

High

entrance of SVC

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20
Q

ATRIAL SEPTAL DEFECT: Sinus venosus

• Associated with anomalous connections of ______________ to the right atrium

A

right pulmonary veins

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21
Q

ATRIAL SEPTAL DEFECT: Clinical features

•_____ to ______ shunt

• Initially (cyanotic or acyanotic?)

• Increased _______ blood flow

A

Left to right

Acyanotic

pulmonary

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22
Q

ATRIAL SEPTAL DEFECT: Clinical features

• Small ASDs are (poorly or well?) tolerated, (asymptomatic or symptomatic?)

•Large ASDs usually manifest around age ____

• _________ is a late consequence because the ________________________

A

Well; asymptomatic

30

Pulmonary hypertension

lungs cant tolerate increased blood flow

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23
Q

ATRIAL SEPTAL DEFECT: Clinical features

• When pulmonary hypertension occurs, it results in
• - _______
• -_______ difficulty
• -________ failure
•__________ is rare
•_________ embolus or _______ occurs when blood flow is reversed

A

cyanosis

respiratory

Cardiac

Infective endocarditis; Paradoxical

brain abscess

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24
Q

__________ is the most common congenital anomaly

A

VENTRICULAR SEPTAL DEFECT

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25
Q

VENTRICULAR SEPTAL DEFECT

It is associated with other anomalies
•_____% are isolated
• It may present at birth, later in life or in adulthood

A

30

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26
Q

VENTRICULAR SEPTAL DEFECT

• It may be
• - ________(___%),and (single or multiple?)
• - __________(____%)

A

muscular; 10; multiple

membranous;90

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27
Q

Ventricular septal defect

Functional severity depends on the _____ and presence or absence of _______

A

size

pulmonary stenosis

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28
Q

VENTRICULAR SEPTAL DEFECT: Small defects

• are ‘ ________ ’

•____% close spontaneously

• are (poorly or well?) tolerated

A

muscular

50

Well

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29
Q

VENTRICULAR SEPTAL DEFECT

•____________ and _________ are present from birth

• Small defects produce ________ and predisposition to ________

A

Right ventricular hypertrophy and pulmonary hypertension

jet streams

infective endocarditis

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30
Q

PATENT DUCTUS ARTERIOSUS
• This occurs when the normal _________ channels during intra-uterine life remains open after birth

A

aorto-pulmonary vascular

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31
Q

PATENT DUCTUS ARTERIOSUS

• Increased ______ after birth and changes in _____ contribute to the constriction and closing of the DA, normally

A

oxygen tension

Prostaglandin

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32
Q

PATENT DUCTUS ARTERIOSUS

• After birth, it may remain open, especially in ______ babies due to ________

•___-___% are isolated, others have ____

A

premature

low oxygen levels

85-90; VSD

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33
Q

PATENT DUCTUS ARTERIOSUS: Clinical presentation

• Presents with a _______(____) murmur
• (Acyanosis or Cyanosis?) initially

A

machinery (pan systolic)

Acyanosis

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34
Q

PATENT DUCTUS ARTERIOSUS: Clinical presentation

eventual Pulmonary hypertension with reversal of shunt , leading to:

•_______,________,______
•____________ failure

A

Cyanosis, finger clubbing, polycythaemia

Right ventricular

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35
Q

PATENT DUCTUS ARTERIOSUS • Clinical presentation
• Acyanotic heart disease is converted to cyanotic heart disease because ________________________ which ought not to be so.

A

the pulmonary tension is higher than the systemic tension

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36
Q

PATENT DUCTUS ARTERIOSUS • Clinical presentation

• Red blood cells are produced in increased amount because ______________ leading to polycythaemia

A

the body senses hypoxia

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37
Q

PATENT DUCTUS ARTERIOSUS • Clinical presentation

• Right ventricular ______ over time leads to ______ which causes heart failure

A

hypertrophy

dilation

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38
Q

ATRIOVENTRICULAR SEPTAL DEFECT

• Failure of fusion of the ___________________________ results in (complete or incomplete?) closure of the _______ and the inadequate formation of the ____________ and __________ leaflets

A

superior and inferior endocardial cushions

Incomplete ; AV septum

septal tricuspid and anterior mitral

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39
Q

ATRIOVENTRICULAR SEPTAL DEFECT

• The commonest abnormality is
• -_____ AV septal defects
• -_______ AV septal defect and a ________

A

partial

complete; large common AV valve

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40
Q

ATRIOVENTRICULAR SEPTAL DEFECT: Partial AV septal defects

•involves ________ and _____________

• Causing ______ insufficiency

A

Primum ASD and left anterior mitral leaflet

mitral valve

41
Q

ATRIOVENTRICULAR SEPTAL DEFECT: Complete AV septal defect and a large common AV valve

• in this , ________________
• It is associated with _________

A

All 4 valves communicate

Down’s syndrome

42
Q

EISENMENGER’S SYNDROME
•_______________ heart disease

• These are cases of _____,____,____,_____

• With _________ and reversal of flow

A

Late cyanotic

VSD, ASD, PDA and AVSD

pulmonary hypertension

43
Q

EISENMENGER’S SYNDROME

• Usually the original lesions are (reparable or irreparable?) at this stage

• Therefore, the repair should be done before ___________________

A

irreparable

pulmonary hypertension builds up

44
Q

CYANOTIC CONGENITAL HEART DISEASES

List 5

A

• TETRALOGY OF FALLOT
• TRANSPOSITION OF GREAT VESSELS
• TRUNCUS ARTERIOSUS
• TRICUSPID ATRESIA usually with ASD
• TOTAL ANOMALOUS PULMONARY VENOUS CONNECTION

45
Q

most common CYANOTIC CONGENITAL HEART DISEASE is ?

A

TETRALOGY OF FALLOT

46
Q

TETRALOGY OF FALLOT
• It has 4 components
• 1- _________
• 2- ________
• 3- ____________
• 4- ______________

A

membranous VSD

overiding aorta

subpulmonary stenosis

right ventricular hypertrophy

47
Q

TETRALOGY OF FALLOT

• Embryology results from ______________ of the _____________

A

anterior-superior displacement

infundibular septum

48
Q

TETRALOGY OF FALLOT: Morphology

•_____ shaped heart
•___ size of _______
•________ stenosis, _______ stenosis or atresia of valves and arteries

A

Boot

VSD ; aortic orifice

Subpulmonary

pulmonary valve

49
Q

TETRALOGY OF FALLOT: Morphology

•_______ is required for survival if there is __________ of _______ valves

• Other features include ______ or ________ insufficiency
•_____________ in 20% of cases

A

PDA

atresia of pulmonary valves

ASD or aortic valve

Right aortic arch

50
Q

TETRALOGYOFFALLOT: Clinical Features

• Depends on the severity of ________

A

pulmonary obstruction

51
Q

TETRALOGYOFFALLOT: Clinical Features

Those with _____ and mild pulmonary obstruction have left to right shunts and are refered to as ________

A

large VSD

Pink Tetralogy

52
Q

TETRALOGYOFFALLOT: Clinical Features

Others will present with _______, __________ , ______ and in the very severe forms the baby is usually found in the _______ position

A

cyanosis

polycythemia

finger clubbing

squatting

53
Q

TETRALOGY OF FALLOT

good Prognosis

• If there is ______
- The ______ are _______

A

no atresia

lungs are protected

54
Q

TRANSPOSITION OF GREAT VESSELS

• The _______ arises from the Left ventricle and the _____ from the
Right ventricle

A

pulmonary trunk

aorta

55
Q

IN TRANSPOSITION OF GREAT VESSELS

_____________ blood is circulated throughout the body

A

deoxygenated

56
Q

TRANSPOSITION OF GREAT VESSELS

• If _____ is present, the degree of cyanosis is ___eased
• If _____ is absent, the baby may _______

A

PDA; decr

PDA; die soon after birth

57
Q

TRANSPOSITION OF GREAT VESSELS

• There are 2 types of this condition
• 1) _______
• 2)__________

A

Complete

Incomplete

58
Q

TRANSPOSITION OF GREAT VESSELS: Complete TGA

•results from the abnormal
formation of __________

• The aorta arises from the _____, lies (anterior or posterior?) and to the (left or right?) of the pulmonary trunk

A

truncal aortic septae

Right ventricle ; anterior

Right

59
Q

TRANSPOSITION OF GREAT VESSELS
• Complete TGA

It occurs commonly in offsprings of _______ mothers

A

diabetic

60
Q

Complete TGA is incompartible with life

T/F

A

T

61
Q

Transposition of Great vessels

TGA with associated ______ has stable
shunt while those with ——- have unstable shunt

A

VSD

PDA

62
Q

TRUNCUS ARTERIOSUS

• This occurs when there is a failure of _____ and ______ of the _______ of the ____ and _____ that would ordinarily divide into the aorta and pulmonary Trunk respectively

A

fusion and descent

spiral ridges

truncus and cornua

63
Q

TRUNCUS ARTERIOSUS

• When the _____ fails to completely divide, the aorta and pulmonary trunk are left undivided at their outflow

A

spiral septum

64
Q

TRUNCUS ARTERIOSUS

The truncus overrides only the left ventricle

T/F

A

F

The truncus overrides both ventricles

65
Q

TRUNCUS ARTERIOSUS

The persistent truncus are always accompanied by _______________

A

membranous VSD

66
Q

TRUNCUS ARTERIOSUS
• The truncal valve resembles the _____ and ______ valves and may have __,___, or ___ cusps

A

tricuspid and aortic

2, 4 or 5

67
Q

TRUNCUS ARTERIOSUS

• May be associated with other defects such as:
•___________
•_________ pulmonary arteries
• Absence of the _________
•_________ hypoplasia

A

Right aortic arch

Hypoplastic

ductus arteriosus

Pulmonary

68
Q

TRICUSPIDATRESIA

This occurs when there is __________________ with a (smaller or larger?) than normal _____ valve

A

an unusual division of the atrio-ventricular canal

Larger ; mitral

69
Q

TRICUSPIDATRESIA

• Circulation is maintained through a _____ or a ______

• May be associated with hypoplasia of the ________

A

VSD; PDA

right ventricle

70
Q

TRICUSPIDATRESIA

•_______ is usually present to channel blood from the right atrium to the left atrium
• This is necessary for the _____ to function

A

ASD

VSD

71
Q

TRICUSPIDATRESIA

May be associated with ______________ syndrome

A

hypoplastic right heart

72
Q

TOTAL ANOMALOUS PULMONARY VENOUS CONNECTIONS

• The ________ do not return to the ____

• They connect to the ________, _______ or some other anomalous sites
• The blood is thus returned to the _______

A

pulmonary veins; left atrium

innominate veins

coronary sinus

right atrium

73
Q

In TOTAL ANOMALOUS PULMONARY VENOUS CONNECTIONS

• There is overload of the _____ side of the heart

•_______ provide free flow of oxygenated bld to the left side of the heart

A

right

An ASD

74
Q

OBSTRUCTIVE CONGENITAL LESIONS

______________
________________
_______________

A

• COARCTATION OF THE AORTA

• PULMONARY STENOSIS

• AORTIC STENOSIS

75
Q

Narrowing of the aorta is a rare structural abnormality

T/F

A

F

Common

76
Q

COARCTATION OF THE AORTA

• _________ of the aorta is a common structural abnormality

• M:F–___:____

A

Narrowing

3-4:1

77
Q

COARCTATION OF THE AORTA

Associated with ________ Syndrome or ______ aneurysm in the brain

A

Turner’s

Berry

78
Q

COARCTATION OF THE AORTA

• There are 2 classical forms

• 1. _________ or ______
• 2. _______ or ________

A

Infantileorpreductal

Adult or postductal

79
Q

Ductal refers to _________

A

ductus arteriosus

80
Q

COARCTATION OF THE AORTA: Clinical Features
•This depends on the ____________

A

severity of the coarctation

81
Q

COARCTATION OF THE AORTA: Clinical Features

• -PreductalCoarctation
• Usually presents in _______
• Majority (will or will not?) survive the neonatal period without surgical intervention
• ______ is necessary for survival

A

childhood

Will not

PDA

82
Q

COARCTATION OF THE AORTA: Clinical Features

PreductalCoarctation

• Cyanosis of the ______ due to the delivery of ________ through the ____

• ________ vessels are spared

A

lower extremities

unsaturated blood

PDA

Upper limb

83
Q

COARCTATION OF THE AORTA: Clinical Features

Postductal coarctation
• The ductus is closed and narrowing is ____________
• Majority of the children are (symptomatic or asymptomatic?)
• Xterized by _______ of the upper limb and lower BP of lower limb

A

beyond origin of carotid vessels

assymptomatic

hypertension

84
Q

COARCTATION OF THE AORTA: Clinical Features

Postductal coarctation

•Features of arterial insufficiency (esp.in the ____)

• __________ develops between the precoarctation arterial branches and post coarctation arteries (internal mammary aa, arterial bld flow from branches of subclavian aa are directed to thoracic aorta)

A

Lower limb

collateral circulation

85
Q

COARCTATION OF THE AORTA: Clinical Features

Postductal coarctation

• X-rays show _____ of the ______ of the ribs, due to ______ that involve the _______

A

notching; undersurface

collaterals

intercostal arteries

86
Q

COARCTATION OF THE AORTA: Clinical Features
• _______

• _________ due to LVH

• Untreated, death comes by the age of ___ years due to ______

A

Murmurs

Cardiomegaly

40; CCF

87
Q

COARCTATION OF THE AORTA: Clinical Features

• Intracranial _______
• Infective ________
• Vascular ______
• Aortic _______ (due to degenerative changes)

A

haemorrhage

endocarditis

rupture

dissection

88
Q

PULMONARY STENOSIS

May be isolated or associated with
• -_______
• -________
• -____________ valve

A

TOF

Transposition

Dysplastic tricuspid

89
Q

PULMONARY STENOSIS

• When the valve is completely atretic, there is a __________ and ______

A

hyperplastic right ventricle and an ASD

90
Q

PULMONARY STENOSIS
• In pulmonary atresia, blood passes through _____ to ______ and into the lungs

A

an ASD to PDA

91
Q

PULMONARY STENOSIS

• The pulmonary trunk is hypoplastic if there is a __________ as in _____

A

subpulmonary stenosis

TOF

92
Q

PULMONARY STENOSIS is Associated with RVH

T/F

A

T

93
Q

AORTIC STENOSIS AND ATRESIA
• This is usually associated with ______ of the _________ tract with ______________ syndrome

A

underdevelopment

left ventricular outflow

hypoplastic left ventricular

94
Q

AORTIC STENOSIS AND ATRESIA

• Isolated in ___% of cases

A

80

95
Q

AORTIC STENOSIS AND ATRESIA

• there are 3 major types
• 1-_____
• 2- ________
• 3- _______

A

valvular

subvalvular

supravalvular

96
Q

AORTIC STENOSIS AND ATRESIA

Supra valvular stenosis is narrowing __________.

Usually ________.

Also seen in ______ syndrome ( ________ in ________ )

A

above the aortic valve

inherited

William; hypercalcaemia in children

97
Q

AORTIC STENOSIS AND ATRESIA

________ is the most common form .

A

Valvular

98
Q

AORTIC STENOSIS AND ATRESIA
Subvalvular stenosis includes obstruction by a _________ or by _____________

A

fibrous band

asymmetric muscular hypertrophy.

99
Q

A unicuspid aortic valve is fatal

T/F

A

T

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