Congential Heart Disease Flashcards Preview

ESA 2- Cardiovascular System > Congential Heart Disease > Flashcards

Flashcards in Congential Heart Disease Deck (92):
1

How common is congenital heart disease?

Common Incidence of 6-8 per 1000 births

2

What is the most common type of congenital heart defect?

Ventricular septal defects

3

What is the second most common type of congenital heart disease?

Atrial septal defects

4

What happens in transposition of the great vessels?

The septum that forms in truncus anteriosus does not take spiral course, meaning that the great vessels are not connected to the correct chambers

5

What is the Tetralogy of Fallot?

A group of 4 lesions occurring together

6

What is the Tetralogy of Fallot a result of?

A single development defect

7

What does Tetralogy of Fallot do?

Places the outflow portion of interventricular septum too far in anterior and cephalad directions

8

What can cause CHD?

Genetics
Environment 
Maternal infections

9

What environmental factors can cause CHD?

Tetragenicity from drugs, alcohol etc

10

Give two examples of maternal infections that can cause CHS?

Rubella 
Toxoplasmosis

11

What does a left to right hunt require?

A hole

12

What happens when there is a left to right shunt?

Blood from left heart returns to the lungs instead of going to the body

13

Is increased lung blood flow damaging?

Not by itself

14

What is the problem with a left to right shunt?

Increased pulmonary artery or pulmonary venous pressure can be damaging

15

What does a right to left shunt require?

A hole and distal obstruction

16

What is the problem with a right to left shunt?

Deoxygenated blood bypasses the lungs

17

What is an acyanotic heart defects?

Defects that do not result in a lower than normal concentration of oxygen in the blood

18

Give 5 acyanotic heart defects

Atrial septal defect 
Patent Foramen Ovale 
Ventricular septum defect 
Patent Ductus Arteriosus 
Coarctation of Aorta

19

What is an atrial septal defect?

An opening in the septum between two atria that persists following birth

20

What is the incidence of atrial septal defects?

67 in 100,000 live births

21

What does the foramen ovale do?

It exists prenatally to permit right to left shunting of oxygenated blood

22

What is the foramen ovale designed to do?

Close promptly after birth

23

What does failure of the foramen ovale to close allow?

Blood to continue to flow between the two atria postnatally

24

In what direction is flow when there is an atrial septal defect?

Mainly from left to right

25

Why is the flow mainly from left to right when there is an atrial septal defect?

Because left atrial pressure is greater than right atrial pressure

26

What is the result of the flow mainly being from left to right when there is an atrial septal defect?

There is no mixing of deoxygenated blood with oxygenated blood being pumped around the circulation

27

Where do ASD’s occur?

Almost anywhere along the septum

28

What is the most common site for ASDs?

The foramen ovale

29

What is it called when the atrial septal defect is at the foramen ovale?

An ostium secundum ASD

30

Where does an ostium primum ASD occur?

At the inferior part of the septum

31

What are the haemodynamic effects of ASD’s?

Increased pulmonary blood flow

32

What is the result of an increased pulmonary blood flow?

Right ventricular volume overload, leading to eventual right heart failure

33

Is a patent foramen ovale a true ASD?

No

34

What is the prevalence of a patent foramen ovale?

May be present in ~20% of the population

35

What is the result of a patent foramen ovale?

Generally, clinically silent

36

Why is a patent foramen ovale generally clinically silent?

Since higher left atrial pressure causes functional closure of the flap valve

37

How can a patent forman ovale cause problems?

It may be a route by which venous embolism reaches the systemic circulation, if the pressure on the right side of the heart increases even transiently

38

What is it called when a patent foreman ovale causes a venous embolism in the systemic circulation?

A paradoxical embolism

39

What is a ventricular septum defect?

An opening in the interventricular septum

40

Where can a ventricular septum defect occur?

At any point

41

Where does a ventricular septum defect most commonly occur?

In the membranous portion of the septum

42

What are the haemodynamic effects of a ventricular septum defect?

Left to right shunt

43

Why does a ventricular septum defect cause a left to right shunt?

Because the left ventricular pressure is much higher than the right

44

What is the result of the left to right shunt?

Left ventricular volume overload, causing pulmonary venous congestion

45

What does pulmonary venous congestion eventually lead to?

Pulmonary hypertension

46

What is the ductus arteriosus?

A vessel that exists in the foetus to shunt blood from pulmonary artery to aorta before lungs are functional

47

What should happen to the ductus arteriosus shortly after birth?

It should close

48

Why does the ductus arteriosus close shortly after birth?

As pressure in the pulmonary artery drops following perfusion of lungs

49

What does failure of the ductus arteriosus to close cause?

Patent ductus arteriosus

50

In what direction would blood flow through the ductus arteriosus after birth?

From the aorta to the pulmonary artery

51

Why would blood flow from the aorta to the pulmonary artery if the ductus arteriosus remained open after birth?

Because its going from a high pressure to a low pressure

52

What is heard when the ductus arteriosus is patent?

A mechanical murmur is heard constantly throughout systole/diastole

53

Why can a mechanical murmur be heard when there is a patent ductus arteriosus?

Because pressure in the aorta is always greater than in the pulmonary artery

54

Does left to right shunting of blood cause cyanosis?

No

55

What does the extend of the problem caused by a patent ductus arteriosus depend on?

The degree of shunting

56

What does chronic left to right shunting lead to?

Vascular remodelling of pulmonary circulation, and an increase in pulmonary resistance

57

What happens if the pulmonary circulation increases beyond that of the systemic circulation due to a patent ductus arteriosus?

The shunt will reverse direction

58

What is it called when the shunt caused by a patent ductus arteriosus reverses direction?

Eisenmeger syndrome

59

What is coarction of the aorta?

Narrowing of the aortic lumen in the region of the liganentum arteriosum

60

What makes up the liganentum arteriosum?

The former ductus arteriosus

61

What may coarction of the aorta lead to?

An increase in afterload on the left ventricle

62

What does an increase in afterload on the left ventricle lead to?

Left ventricular hypertrophy

63

What is the effect of a coarctation of the aorta?

Blood flow to the body is reduced

64

Where is blood flow not reduced when there is a coarctation of the aorta?

The head and upper limb

65

Why is the blood supply to the head and upper limb not affected when there is coarctation of the aorta?

Because the vessels to these areas usually emerge proximal to coarctation

66

What does extent of the symptoms of coarctation of the aorta depend on?

The severity of the coarctation

67

What may happen with severe coarctation of the aorta?

Infant may present with symptoms of heart failure shortly after birth

68

What may happen in mild cases of coarctation of the aorta?

Defect may be detected in adult life

69

What are the symptoms of coarctation of aorta?

Femoral pulses weak and delayed 
Upper body hypertension

70

Give 4 cyanotic heart defects?

Tetralogy of Fallot 
Tricuspid Atresia
Transposition of the great arteries 
Hypoplastic left heart

71

What is Tetralogy of Fallot?

A group of 4 lesions occuring together as a result of a single developmental defect placing outflow portions of the interventricular septum too far in anterior and cephalad directions

72

What are the 4 abnormalities in Tetralogy of Fallot?

VSD
Overriding aorta 
Pulmonary stenosis 
Right ventricular hypertrophy

73

To what degree are pulmonary stenosis and right ventricular hypertrophy present in Tetralogy of Fallot?

Variable

74

What does pulmonary stenosis cause?

Persistance of foetal right ventricular hypertrophy

75

Why does pulmonary stenosis cause right ventricular hypertrophy?

As the right ventricle must operate at a much higher pressure to pump blood through the pulmonary artery

76

What aspects of the Tetralogy of Fallot allow right to left shunting?

Increased pressure on the right side of the heart 
VSD
Overriding aorta

77

What is the result of right to left shunting?

A mix of deoxygenated blood with oxygenated blood going into the systemic circulation, resulting in cyanosis

78

What does the magnitude of the shunt and the severity in Tetralogy of Fallot depend on?

The severity of pulmonary stenosis

79

When does Tetralogy of Fallot present?

May present in infancy 
Mild cases can present in adulthood

80

What is Tricuspid Atresia?

Lack of development of tricuspid valve

81

What is the problem with tricuspid atresia?

It leaves no inlet to the right ventricle

82

What must be present in tricuspid atresia?

A complete right to left shunt of all blood returning to the right atrium (ASD or PFO) and a VSD or PDA to allow blood flow to the lungs- there needs to be a right to left shunt of the entire venous return

83

What does transposition of the great arteries result in?

Two unconnected parallel circulations, instead of two in series

84

What has happened in transposition of the great arteries?

The right ventricle is connected to aorta and the left ventricle to pulmonary trunk

85

What is the prognosis for a patient with transposition of the great arteries?

Condition not compatible with life after birth, unless a shunt exists to allow to two circulations to communicate

86

How can a patient with transposition of the great arteries be treated?

A shunt must be maintained, or created immediately following birth to sustain life until surgical correction can be made

87

What shunt can allow a patient with transposition of great arteries to survive until after birth?

Ductus arteriosus can be maintained patent and/or an atrial septal defect formed

88

What happens in hypoplastic left heart?

The left ventricle and ascending aorta fail to develop properly, meaning the ascending aorta is very small

89

What must happen when there is a hypoplastic left heart?

The right ventricle supports systemic circulation

90

What is also present with hypoplastic left heart?

PFO or ASD

91

What supplies the systemic circulation with hypolastic left heart?

Via a PDA

92

What happens if a hypoplastic left heart is not surgically corrected?

It is lethal