Congenital Heart Disease

Question 1

What is the definition of congenital heart disease?

Answer 1

Abnormalities of the heart’s structure that are present at birth

Question 2

Congenital heart disease affects ____ out of every ____ newborns.

Answer 2

1 out of every 125

Question 3

Each year, more than ____-____ babies in the United States are born with congenital heart defects.

Answer 3

35,000 - 40,000

Question 4

What are the three types of CHD?

Answer 4

Shunt lesions, obstructive lesions, and cyanotic lesions.

Question 5

What are some examples of shunt lesions?

Answer 5

ASD, VSD, PDA, PFO

Question 6

What are some examples of obstructive lesions?

Answer 6

Pulmonary stenosis, pulmonary atresia, tricuspid atresia, or Ebstein’s anomaly.

Question 7

What are some examples of cyanotic lesions?

Answer 7

Double outlet right ventricle (DORV), Total anomalous pulmonary vein return (TAPVR), Transposition of the great arteries (TGA), Truncus arteriosus, Single ventricle, Eisenmenger syndrome, Hypoplastic left heart syndrome (HLHS), Tetralogy of Fallot (TOF).

Question 8

The endocardium and the cardiac jelly participate in the formation of the ____.

Answer 8

Endocardial cushions

Question 9

The outer myocardial mantle eventually becomes the ____.

Answer 9

Muscular wall of the heart

Question 10

What are the five areas of the heart tube?

Answer 10

Sinus venosus, common atrium, common ventricle, bulbus cordis, truncus anteriosus.

Question 11

What does the sinus venosus eventually form?

Answer 11

The proximal vena cava (SVC and IVC)

Question 12

What does the common atrium eventually form?

Answer 12

RA and LA

Question 13

What does the common ventricle eventually form?

Answer 13

RV and LV

Question 14

What does the bulbus cordis eventually form?

Answer 14

The RVOT and LVOT

Question 15

What does the truncus anteriosus eventually form?

Answer 15

The roots of the aorta and pulmonary arteries

Question 16

At what week does the heart begin to loop?

Answer 16

Week 4

Question 17

At ____-____ weeks the heart is fully developed and any CHD that is going to be present has occurred.

Answer 17

6 - 8

Question 18

The left side of the sinus venosus eventually…

Answer 18

Is obliterated

Question 19

The right side of the sinus venosus eventually…

Answer 19

Becomes incorporated into the RA as it grows (this fold is the eustachian valve).

Question 20

As the cardiac tube begins to loop, the truncus anteriosis and bulbus cordis begin to movie ___.

Answer 20

Down and to the right

Question 21

As the cardiac tube begins to loop, the primitive ventricle begins to move ___.

Answer 21

Left of the midline

Question 22

As the cardiac tube begins to loop, the primitive atria begin to move ____.

Answer 22

Posterior (back) and superior

Question 23

When does the atrial septal formation begin?

Answer 23

At the end of week 4

Question 24

A small opening near the atrioventricular valves permits continued communication between the two ventricles until later when it is closed by the ____ and ____ portions of the IVS.

Answer 24

Membranous and perimembranous

Question 25

What do the endocardial cushions form?

Answer 25

The septal TV leaflet, the anterior MV leaflet, and a portion of the inflow perimembranous IVS.

Question 26

What do the lateral cushions form?

Answer 26

The anterior and posterior TV leaflets and the posterior MV leaflet.

Question 27

What happens to the third set of aortic branches?

Answer 27

The common and internal carotid artery

Question 28

In what week do the aortic arches form?

Answer 28

Week 4

Question 29

What happens to the left fourth set of aortic branches?

Answer 29

The aorta

Question 30

What happens to the sixth set of aortic branches?

Answer 30

The right and left pulmonary arteries

Question 31

What happens to the first and second set of aortic branches?

Answer 31

They just disappear

Question 32

A right-sided liver and left-sided stomach is usually associated with atrial situs ____

Answer 32

Solitus

Question 33

Morphologic RA always contains the ____ valve.

Answer 33

Eustachian

Question 34

The appendage of the ____ ____ is shorter and broader than that of the LA.

Answer 34

Morphologic RA

Question 35

Morphologic LA has no eustachian valve and has a more ____ shape than the right atrium.

Answer 35

Rounded

Question 36

Normally the aorta lies to the ____.

Answer 36

Left

Question 37

The IVC lies to the ____ of the spine.

Answer 37

Right

Question 38

____ ____ connect to the LA normally; however, you cannot use the connection as a deciding factor for atrial situs or morphology.

Answer 38

Pulmonary veins

Question 39

True or false: You can have atrial situs but have abnormal pulmonary vein connections.

Answer 39

True

Question 40

Atrial situs is best determined in the ____ view.

Answer 40

Subcostal

Question 41

What are the three steps to the segmental approach?

Answer 41

1: Determine atrial situs and assess venous inflow patterns to the atria (SVC, IVC, Pulm veins) 2: Determine atrioventricular connections and determine ventricular morphology and position. 3: Evaluate ventriculoarterial relationships.

Question 42

D-looping allows the RV to develop ____ and to the ____ of the LV.

Answer 42

Anteriorly; right

Question 43

With L-looping the morphologic RV is to the ____ of the morphologic LV

Answer 43

Left

Question 44

What anatomy markers are part of the RV?

Answer 44

- has muscle bundles - moderator band - heavily trabeculated

Question 45

What anatomy markers are part of the LV?

Answer 45

- has a smooth endocardial surface - two papillary muscles

Question 46

The ____ valves ALWAYS follow the corresponding ventricle.

Answer 46

AV valves

Question 47

The leaflets of the TV insert more ____ than MV.

Answer 47

Apically

Question 48

The TV usually has ____ papillary muscles.

Answer 48

Three

Question 49

The MV has a more ____ septal attachment.

Answer 49

Basal

Question 50

The MV usually has ____ papillary muscles.

Answer 50

Two

Question 51

The ____ has chordal insertions into the septum, while the ____ does not.

Answer 51

TV; MV

Question 52

The final step in the segmental approach to cardiac anatomy involves identification of the ____ ____ and their respective connections.

Answer 52

Great arteries

Question 53

Normally with concordant connections, the morphologic LV gives rise to the ____.

Answer 53

Aorta

Question 54

Normally with concordant connections, the ____ serves as the outlet of the RV.

Answer 54

Pulmonary artery

Question 55

In normal hearts the pulmonary artery sits ____ and ____.

Answer 55

Anterior and leftward

Question 56

In normal hearts the aorta sits ____ and ____.

Answer 56

Posterior and rightward

Question 57

In normal hearts the aortic arch goes to the ____.

Answer 57

Left

Question 58

____-transposition, ventricular relationship is normal, with the morphologic RV located to the right of the morphologic LV.

Answer 58

D-transposition

Question 59

____-transposition, atrioventricular discordance is present (because of formation of an L-loop during development), the morphologic RV lies to the left of the morphologic LV.

Answer 59

L-transposition