congenital heart disease Flashcards
ASD (atrial septal defect)
hole in the heart. gap in the atrial septal wall. this means a mix od oxygenated and deoxygenated blood. fluid will move from higher pressure to lower pressure using the easiest route, pressures are higher in the left side of the heart so a left-to-right shunt will take place. so when the atria contracts some will also go into the right atrium. this increases the volume in the right atria. because the heart responds to changes in pressure and volume, it will have to work hrder to push that extra volume from the right atria to the right ventricle. because it is a muscle working harder it can get thicker. but what can also happen is it can stretch due to the extra volume. when this blood goes to the lungs, because the lungs are also being stretched and theres higher pressure, the. blood vessels thicken, this increases pressure in the lungs and causes pulminary hypertension.
type of ASD, sacundum
in the middle, so often it closes naturally as the muscle grows. if hole is too big, cant wait for it to close naturally due to volume movement being higher so higher chance of heart failure.
type of ASD, sinus venosus
in the upper part of septum, really rare, doesnt close naturally.
type of ASD, primum
lower part of septum, does not close naturally
closure procedure for ASD
insert a catheter into right side of the heart, move it across into the defect. deploy umbrella ans pull it back, deploy another umbrella, it clips and closes and over time the muscle will integrate the catheter into itself.
ventricular septal defect (VSD)
higher pressure in the left side of the heart means left to right shunt. mixing oxygenated and deoxygenated blood in the ventricles. this directly affects the ventricles, it increases the volume in the right ventricle. A lot will go up through the aorta but will cause volume overload in pulmonary arteries. when left untreated can cause heart failure due to thickening od the heart muscle losing its mobility and contractility. VSD is closed with a patch if surgery is needed.
aortic valve stenosis
stiffening of the valve. aortic valve has the most pressure. with aortic valve stenosis, the valve is thich or has growth on it so it cant close. this means blood can go back when the ventricle contracts. this causes wear and tear on the valve because the blood will force its way through due to it not opening properly. symptoms: shortness of breath, chest pain, extra beats (arrhythmias) which can cause fainting.
treatment: surgical aortic valve replacement, valvuloplasty
an aortic valve usually has three leaflets, a bicuspid valve means two of the leaflets haven’t separated, instead of 3 valves opening and closing, its two.
pulminary valve stenosis
second highets pressure valve. causes lac of blood going to the lungs. muscle gets thicker over time as it has to push the blood out harder, so right ventricular hypertrophy symptoms: cyantic (going blue) as theres lack of blood going to the lungs. treatment: valvuloplasty, valve replacement.
transposition of the great arteries (TGA)
aorta can be attached to the right ventricle, meaning deoxygenated blood is being pumped around the body. because the heart is in the womb it is still getting the oxygenated blood it needs while its in the mother’s body. treatment: arterial switch procedure, move the pulmonary artery back on the right side and the aorta back onto the left side.
tetralogy of fallot (TOF)
have qa VSD (hole in heart)
have an overarching aorta which sits over the right and left ventricle, so theres a mixture of oxygenated blood and deoxygenated blood going through the aorta. can also have pulmonary stenosis, the pulmonary valve doesn’t open and close properly. this causes right ventricular hypertrophy because it enlarges.
treatment: shunt but when baby is strong enough, everything gets repaired.
Coarctation of the aorta
narrowing artery, so reduced amount of blood to the lower body, but increased volume and pressure up to the head. Symptoms: headaches, hypertension, leg aches. Treatment: open up the narrowing with a balloon or cut out the narrowing and sew it back together.
hypoplastic left or right heart
where the chambers havent developed properly and becomes a single pump vessel. in this case you keep the ASD open so have a mixture of oxygenated and deoxygenated blood in the remaining ventricle and ensure that gets around the bosy and lungs.
