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Cardio > Congenital Heart Disease > Flashcards

Congenital Heart Disease Flashcards

1
Q

What are the four sources of shunting in fetal circulation?

A

1) placenta

2) ductus venosus (liver)

3) foramen ovale

4) ductus arteriosus

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2
Q

What does the foramen ovale do?

A

shunts blood from right to left

allows you to take blood directly to brain

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3
Q

What can cause a small head?

A

transposition of great arteries

oxygenated blood isn’t going to the head since it is getting shunted to the pulmonary veins

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4
Q

What allows blood to bypass lungs?

A

ductus arteriosus

connects aorta to pulmonary artery

allows oxygenated blood to bypass the lungs

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5
Q

What happens to foramen ovale at birth?

A

higher LAP shuts it closed

pressure snaps the door shut

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6
Q

What is the foramen ovale?

A

hole between the left / right side of the heart

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7
Q

What two values drop at birth?

A

pulmonary resistance and pulmonary pressure

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8
Q

What 2 things close the ductus arteriosis?

A

1) PaO2 increases

2) prostaglandin drops

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9
Q

What forms the aorticopulmonary septum?

A

neural crest cells

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10
Q

What can lead to transposition of great vessels, ToF, etc?

A

aorticopulmonary septum problems

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11
Q

What is most common form of ASD?

A

secundum ASD from increased reabsorption of septum

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12
Q

What becomes dilated in ASD?

A

the atria from increased volume

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13
Q

What side of heart will become hypertrophied in ASD?

A

right-side due to the left to right shunt

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14
Q

What is a key PE finding of coarctation of aorta?

A

difference in LE and UE blood pressure

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15
Q

What is commonly associated with coarctation of aorta?

A

bicuspid aortic valve

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16
Q

If you hear a murmur in the back, what does this point to?

A

the aorta

17
Q

Is coarctation of aorta a pressure or volume lesion?

A

a pressure lesion due to increased afterload needed

can lead to LVH

18
Q

What causes coarctation of aorta?

A

problem with ductal arteriosus closure which causes a kink

19
Q

When does ductal arteriosus normally close?

A

5-7 days after birth

20
Q

What happens to aortic flow in coarctation of aorta?

A

continuous flow in diastole since you can’t get blood through

21
Q

What would you do if you have critical CHF with coarctation of aorta?

A

try to keep the DA open through prostaglandin use

22
Q

What are the 5Ts of cyanosis?

A

Truncus arteriosus

Transposition

Tricuspid atresia

Tetralogy of fallot

Total anomalous pulmonary venous return (TAPVR)

23
Q

What type of shunts cause cyanosis?

A

right to left shunts

oxygen poor blood isn’t flowing back to lungs, is flowing the rest of the body

24
Q

Concave MPA segment indicates …

A

tetralogy of Fallot

25
Q

Where is aorta in tetralogy of Fallot?

A

sitting overtop of ventricular septum

26
Q

What makes murmur worse in ToF?

A

more pulmonary stenosis

27
Q

Why does agitation worsen ToF?

A

increased HR means less filling time and less preload

even less oxygenated blood to go through systemic circulation

28
Q

What does cyanosis mean?

A

deoxygenated blood is going to aorta (blue blood) rather than the lungs

29
Q

What does knee to chest do in ToF?

A

increased preload

30
Q

What else can you do to break exacerbation of ToF?

A

decrease HR

give phenyleprine (increase preload without increasing HR)

31
Q

Why can you not give supplemental O2 in ToF?

A

blood isn’t ever going to lungs to get oxygenated

oxygen will not travel into systemic circulation

32
Q

How does TGA present?

A

small head

normal besides cyanosis at birth

33
Q

What happens in TGA?

A

right ventricle pumps into the aorta which circulates deoxygenated blood into system

left ventricle pumps into pulmonary vein and oxygenated blood just circles around lungs

34
Q

How can you fix TGA?

A

tear a hole in the atrial septum to allow more mixing of oxygenated and deoxygenated blood

made ASD / PFO

can also use prostaglandins to help for a little

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