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Flashcards in deck_753791 Deck (35):
1

Define ventricular septal defects

An abnormal opening in the interventricular septum

2

Describe ventricular septal defects

-- usually occurs in the membranous portion of the septum- BLOOD FLOW from left to right due to pressure gradient -- acyanotic-- 25% of all congenital heart defects

3

What can ventricular septal defects cause?

1. LV hypertrophy as LV volume is overloaded2. Pulmonary hypertension after pulmonary venous congestion3. Pneumothorax4. Dyspnoea5. Pulmonary oedema

4

Define atrial septal defect

An abnormal opening in the septum between the two atria which persists following birth

5

Describe atrial septal defect

Foramen ovale fails to close in majority of casesCauses L to R flow -- acyanotic

6

Define patent foramen ovale

Foramen ovale fails to close properly -- higher LA pressure tends to close gap so patients are asymptomatic

7

What are the four anomalies found in tetralogy of fallout?

Ventricular septal defectOverriding aortaPulmonary stenosisRight ventricular hypertrophy

8

What are the main effects of tetralogy of fallot?What determines the severity?

Pulmonary stenosis -- persistent right ventricular hypertrophy as higher pressure os needed to pump bloodCyanosis due to VSD and OA causing R to L shunting. Severity of pulmonary stenosis

9

What are the symptoms of tetralogy of fallot?

Low blood O2Difficulty with eatingFailure to weight gainRetarded growth"Tet spells" -- marked increase in cyanosis followed by syncope. Can cause brain injurt and death

10

Define tricuspid atresia

Lack of development of the tricuspid valve so there is no inlet into the right ventricle-- R to L atrial shunt-- Ventricular septal defect allows flow to lungs-- is incurable as can't replace ventricles

11

Define transposition of the great arteries and give its cause

Two unconnected parallel circuits instead of oneCaused by conotruncal septum not adopting a spiral course

12

Describe transposition of the great arteries

RV connected to aorta. LV connected to pulmonary artery -- causes major cyanosis(deoxygenated blood continues in systemic circulation and oxygenated blood continues in pulmonary circulation)

13

What is the treatment for transposition of the great arteries?

-- need communication as fetus will not be viable-- surgery is required straight after birth

14

Define total anomalous pulmonary venous drainage

ll 4 pulmonary veins drain into the vena cava or the right atrium causing systemic and venous blood to mix in the right atrium.

15

What is univentricular heart?

Both the atria drain into one ventricle.

16

What is hypoplastic left heart?

LV and ascending aorta fail to develop properly. Is lethal without surgery

17

What does hypoplastic left heart cause?

Underdeveloped left ventricleSmall ascending aortaRV supports the systemic circulation via patent foramen ovale or atrial septal defect

18

Define stenosis

abnormal narrowing of a blood vessel

19

Define atresia

absence of abnormal closure of blood vessel

20

What is aortic stenosis?

Abnormal narrowing of aortic valve

21

What are the effects of aortic stenosis?

Valve leaflets are stiff, leads to reduced systolic opening and increased left ventricular pressure.

22

What are the symptoms of aortic stenosis?

Exercise induced anginaSyncopeHeart failure -- due to ischaemia of LV myocardium

23

Define aortic atresia

no left ventricular outlet causing impeded blood flow. The only source of blood flow is via a patent ductus arteriosus

24

Define pulmonary stenosis

Abnormal narrowing of pulmonary valve

25

What are the effects of pulmonary stenosis?What causes it?

-- RV systole is obstructed, so RV and RA become hypertrophied -- tends to be due to a congenital lesion (rubella)

26

What are some symptoms of pulmonary stenosis?

fatigue, syncope and right heart failure

27

Define pulmonary atresia

No right ventricular outlet is present

28

What are the effects of pulmonary atresia?

--R to L shunt of the entire venous system and blood flow to the lungs occurs via a patent ductus arteriosus

29

Define patent ductus arteriosus

Ductus arteriosus does not close and is present after birth. -- connects pulmonary artery to the aorta in the fetus

30

When should the ductus arteriosus close?

After birth, when the lungs receive oxygen and the pressure in the pulmonary artery drops

31

What are the effects of a patent ductus arteriosus?

Causes L to R shunt-- large shunt can lead to pulmonary hypertension, vascular remodelling of the pulmonary circulation and increased pulmonary resistance.

32

Define Eisenmenger syndrome

Increased pulmonary resistance can lead to the shunt reversing if pressure is greater than systemic pressure

33

Define coarctation of the aorta

Is a narrowing of the aortic lumen where the ductus arteriosus inserts.

34

What are the effects of coarctation of the aorta?

-- Increases the after load (tension developed in the wall) of the LV -- Causes left ventricular hypertrophy (heart has to pump harder to reach the same outflow)-- Blood flow to lower body and trunk is reduced (vessels emerge from heart distal to coarctation)-- Blood flow to head and neck not affected as they leave proximal to coarctation.

35

What are the symptoms of coarctation of the aorta?

-- babies can be born with signs of heart failure in severe cases. -- mild cases can be detected in adult life.-- femoral pulses are weak and delayed and there will be upper body hypertension.