Flashcards in Congential Heart Disease Deck (92)
What may coarction of the aorta lead to?
An increase in afterload on the left ventricle
What does an increase in afterload on the left ventricle lead to?
Left ventricular hypertrophy
What is the effect of a coarctation of the aorta?
Blood flow to the body is reduced
Where is blood flow not reduced when there is a coarctation of the aorta?
The head and upper limb
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
What does extent of the symptoms of coarctation of the aorta depend on?
The severity of the coarctation
What may happen with severe coarctation of the aorta?
Infant may present with symptoms of heart failure shortly after birth
What may happen in mild cases of coarctation of the aorta?
Defect may be detected in adult life
What are the symptoms of coarctation of aorta?
Femoral pulses weak and delayed
Upper body hypertension
Give 4 cyanotic heart defects?
Tetralogy of Fallot
Transposition of the great arteries
Hypoplastic left heart
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
What are the 4 abnormalities in Tetralogy of Fallot?
Right ventricular hypertrophy
To what degree are pulmonary stenosis and right ventricular hypertrophy present in Tetralogy of Fallot?
What does pulmonary stenosis cause?
Persistance of foetal right ventricular hypertrophy
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
What aspects of the Tetralogy of Fallot allow right to left shunting?
Increased pressure on the right side of the heart
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
What does the magnitude of the shunt and the severity in Tetralogy of Fallot depend on?
The severity of pulmonary stenosis
When does Tetralogy of Fallot present?
May present in infancy
Mild cases can present in adulthood
What is Tricuspid Atresia?
Lack of development of tricuspid valve
What is the problem with tricuspid atresia?
It leaves no inlet to the right ventricle
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
What does transposition of the great arteries result in?
Two unconnected parallel circulations, instead of two in series
What has happened in transposition of the great arteries?
The right ventricle is connected to aorta and the left ventricle to pulmonary trunk
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
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
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
What happens in hypoplastic left heart?
The left ventricle and ascending aorta fail to develop properly, meaning the ascending aorta is very small
What must happen when there is a hypoplastic left heart?
The right ventricle supports systemic circulation