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Flashcards in Congenital Heart Disease Deck (44):
1

The majority of heart disease in children is

Congenital (5 to 8 of every 1000 live births)

2

The three causes of congenital heart disease

Genetic, Environmental, multifactorial (combo of genetic and environmental)
Multifactorial makes up the majority

3

What does congenital mean

A disease that exists at birth or develops during the first month of life.

4

Syndromes with Congenital Heart Disease

Down, Turner, Marfan, Noonan, 18, 13,

5

Infections that can lead to congenital heart disease

Rubella

6

Diseases that lead to congenital heart disease

PKU

7

Drugs that lead to CHD

Thalidomide, Accutane, Trimethadione

8

Toxins that lead to CHD

ALcohol and cocaine

9

One mechanism that can lead to CHD is altered flow patterns during cardiac development

true

10

Decreased right heart flow during cardiac development leads to

Tricuspid Atresia (TAT), Pulmonary Stenosis Valvular (PSV), Atrial septal defect (ASD)

11

Decreased Left Heart Flow

Atrial Septal Defect (ASD), Coarctation of the Aorta, Mitral Atresia (MAT)

12

At birth, systemic resistance does what?

Increases

13

At birth, pulmonary resistance does what?

decreases (lungs expand)

14

At 24 hours, pulmonary resistance is (blank) of systemic resistance

one half

15

Most common CHD

Ventricular septal defect...by a long shot.
Then atrial septal defect, pulmonary stenosis

16

The various CHD abnormalities can be grouped into three categories. They are

abnormalities causing a Left to right shunt, Right to left shunt, and obstruction

17

Dusky blueness of skin. What shunt is it?

Right to left shunt. blood avoids pulmonary circulation

18

Left to right shunt

Expose the low pressure, low reisistnace pulmonary vasculature to increased volume and increased pressure. Leads to increased pulmonary vascular resistance which leads to right heart hypertrophy and eventually failure. With time, this increased resistance can cause reversal of the shunt to right to left.

19

Atresia

Complete obstruction

20

Most common shunt

Left to right...ASDs, VSDs, PDA (patent ductus arteriosus)

21

What does the Foramen ovale do in fetal circulation

Allows blood to flow from the right atrium to the left. Bypasses the fetal lungs.

22

pulmonary hypertension associated with

Left to right shunt. This pulm HTN can lead to a reversal of shunting and thus cyanosis. Seen earlier and more frequently at this severity in VSDs than ASDs.

23

Whats the point of the ductus arteriosus during intrauterine life?

Its like a bridge between the pulmonary artery and the aorta. It permits blood flow from the pulm arteries to the aorta so that blood can bypass the unoxygenated lungs.

24

When is the ductus usually obliterated

First few months of life

25

PDA characteristics.

High pressure left to right shunts. Sounds like machinery in systole

26

Cyanotic CHD (right to left shunt) associated with what conditions

tetralogy of fallot and transposition of the great vessels

27

Physiologic murmurs

PPS, PFO

28

Physiologic murmurs in toddlers

Still's, venous hum, pulmonary flow, carotid bruit

29

Adult phyiologic murmurs

Mammary SOufle

30

Are Physiologic murmurs ver in diastole

NO....only systole

31

Are physiologic murmurs ever associated witha thrill

no

32

Physiologic murmurs localized to left sternal border

yes

33

AV valve murmur during systole

regurgitation...mi, tri, sys, regurg

34

AV valve during diastole

Stenosis

35

Semilunar valves during sys

stenosis

36

Semilunar during diastole

regurg

37

Murmurs of relative stenosis occur when?

When abnormally large amounts of blood flow pass across a structurally normal valve.

38

When is cyanosis typically observed

When the concentration of desaturated Hgb is above 4 gm/dl

39

Cardiac vs. non cardiac causes of cyanosis

Cardiac cause = perfusion of systemic circulation with desaturated blood.

40

Non-cardiac causes of cyanosis

Peripheral vasoconstriction, desaturation of pulmonary venous blood
Desaturation of pulmonary venous blood (hypoventilation, pneumonia, pneumothorax)

41

Hyperoxia test tells you what

Whether the Cyanosis is a problem of the heart or a problem of the lungs. Administer 100% FiO2 by hood or ETT. If PO2 is less than 100, the probability of congenital heart disease goes way up.

42

Cyanotic heart defects

Tunk, tran, tri, tet, tot
Trunkus arteriosus, transposition of the great arteries, Tricuspid atresisa,
Tetralogy of Follot
Total anomalous pulmonary venous return

43

Is an unrestrictive VSD in a newborn likely associated with a murmur

no

44

Unrestrictive VSD in a 2 month old likely associated with what?

Systolic murmur and diastolic rumble