Congenital Heart Disease II Flashcards Preview

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Flashcards in Congenital Heart Disease II Deck (125)
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1

When do symptoms of ASD usually present?

not in infancy- takes a while to develop symptoms

1

What are the long term risks of untreated ASDs?

development of pulm vascular disease atrial arrhythmias HF

1

____ is the most common cyanotic heart defect and accounts for 15% of all congenital heart defects.

Tetralogy of Fallot

2

In Tetrology of Fallot, the RV and LV pressures are _____.

equal

3

Why isn't a murmur going away a good thing?

could be a large VSD with equalizing R and L pressures elevation in PVR

4

When can a VSD be a right to L shunt?

with pulmonary stenosis

5

What are the exam findings with a small VSD?

precordial activity normal normal 2nd heart sound 2-4/6 early systolic murmur NO diastolic rumble

6

DX? 2-3/6 systolic ejection murmur at L upper sternal border with possible diastolic rumble widely split 2nd heart sound

ASD

6

Turner's Syndrome is associated with ______.

coarctation of the aorta

6

Where do coarctations of the aorta occur?

in the descending aorta opposite of the ductus arteriosus or lower

6

DX? 1. tachycardia 2. difference in upper extremity and lower extremity BP 3. pulmonary rales 4. hepatomegaly 5. S2 and S3 gallop 6. soft systolic murmur

Coarctation of the aorta

7

What happens with pulmonary vascular disease at high altitudes?

it's more common and occurs at an earlier age

8

10% of VSDs are which type?

muscular VSDs

8

What are the exam findings with a large VSD?

active precordium loud 2nd heart sound 2-3/6 harsh, holosystolic murmur loudest at the LLSB diastolic murmur

8

How is VSD treated?

diuretics surgical close if muscular

8

How does Tetrology of Fallot present?

1. blue baby 2. loud murmur

9

What are some of the s/s of VSD?

respiratory distress diaphoresis (esp with feeding) failure to thrive tachypnea

10

Dx? hypoxic or hypercyanotic episode, usually in the 2-6th month of life can be life threatening unk mechanism

Tet spell (Tetralogy of Fallot)

11

What are the steps of atrial septal embryology?

1. septum primum closes 2. apoptosis of the middle primum cells to form the osteum secundum 3. septum secundum closes to enclose the foramen ovale

12

What is a fixed split S2 and what is it diagnostic of?

when the S2 is split at any point in the respiration cycle; ASD

12

Why isn't ASD caught at infancy?

there's usually not a loud murmur or symptoms until later in life

13

What are the phys exam findings in a large ASD?

1. increased respiratory rate 2. sweating with feeding 3. hepatomegaly 4. 2-3/6 systolic ejection murmur at L upper sternal border with possible diastolic rumble 5. split 2nd heart sound

14

What is the normal pressure within the LV?

120

15

How is VSD treated?

diuretics surgical close if muscular

16

What will happen in untreated Tetrology of Fallot?

death at the time of ductus arteriosus closure (if severe RVOT obstruction) OR cyanosis, clubbing, poor dental enamel, bleeding tendencies, squat with exercise, arrhythmias AND MAYBE cerebral abscesses

16

Why does a baby develop symptoms of coarctation 2 days to 2 weeks post delivery after being fine at birth?

the ductus arteriosus closes and worsens the problem

18

How does a secundum ASD happen?

the osteum secundum was too large or the septum secundum inadequately develops

19

When should you decide to surgically correct a VSD?

1. pulmonary vascular changes 2. persistent symptoms, failure to thrive 3. 2a complications (aortic insuff, double chambered RV)

19

What is coarctation of the aorta?

a narrowing of the aortic lumen

20

What does the left endocardial cushion become?

posterior leaflet of the mitral valve