Exam 1 - Congenital Heart Defects

Question 1

What is the most common congenital disease?

Answer 1

Congenital Heart Dz

Question 2

What is the most common Congenital Heart Dz?

Answer 2

Ventricular Septal Defect

Question 3

Common risk factors for CHD?

Answer 3

Premarure, FHx, maternal infection in utero, rubella, genetic sundromes

Question 4

Left to Right shunting of blood does what to the size/shape right side of the heart?

Answer 4

Dilates the right side of the heart

Question 5

Right heart dilation causes what to the RV and pulmonary artery?

Answer 5

Decreased RV function and dilated pulmonary artery, then increased pulm vasculature

Question 6

Is Left to Right shunting cyanotic?

Answer 6

No

Question 7

Is Right to Left shunting cyanotic?

Answer 7

Yes

Question 8

Why prenatal US so important?

Answer 8

To catch CHDs. New baby screenings only catch 50%

Question 9

What is an Atrial Septal Defect? Shunt goes which way? Cyanotic?

Answer 9

Hole in atrial septum between RA and LA. Left to right shunting (noncyanotic).

Question 10

Two main types of ASD?

Answer 10

1. Ostium Secundum #1

2. Ostium Primum #2

Question 11

Etiology of Ostium Secundum?

Answer 11

Second walls does not cover second hole d/t growth retardation. Spontaneous vs genetic.

Question 12

Etiology of Ostium Primum?

Answer 12

First and Second Walls don’t fuse to endocardial tissue

Question 13

Is an Ostium Primum isolated?

Answer 13

Usually not isolated. AV Canal defects, VSD, MR….

Question 14

Symptoms of ASD?

Answer 14

Usually asymptomatic. Dyspnea, fatigue, exercise intolerant, recurrent rep infx.

Question 15

Murmur and sounds in ASD?

Answer 15

Midsystolic pulmonary ejection murmur. Fixed-splie S2. Precordial thrill/lift

Question 16

PE in ASD?

Answer 16

Failure to thrive. HF signs (tachycardia, hepatomegaly, ralls), irregular heart beat, IE, Eisnmenger Syndrome (Left to Right shunting, clubbed fingers).

Question 17

EKG on ASD?

Answer 17

Tall P-waves=dilated right heart.

Complete or incomplete RBBB. Right axis deviation.

Question 18

DX ASD gold standard?

Answer 18

Echo

Question 19

Tx for ASD if no Sx and small defect?

Answer 19

Wait until 2

Question 20

Tx for ASD if have Sx?

Answer 20

Surgery or percutaneous transcath repair

Question 21

What percent of adults have a Patent Foramen Ovale?

Answer 21

30%

Question 22

Is PFO an ASD?

Answer 22

Neyt

Question 23

Sx of PFO?

Answer 23

Asymptomatic most ofren.
+/- stroke-like sx
+/- migraine HA

Question 24

PE in PFO?

Answer 24

Cryptogenic stroke (stroke of unknown cause)

Question 25

Dx in PFO?

Answer 25

2d Echo w/doppler

Question 26

Tx in PFO?

Answer 26

Treat if have cryptogenic stroke/TIA. Anticoag, antiplatelet. Surgical closure of PFO.

Question 27

What class of defect is the most common of all CHDs?

Answer 27

Ventricular Septal Defect

Question 28

VSDs are what percent of all septal defects

Answer 28

50%

Question 29

Two main types of VSD?

Answer 29

1. Membranous/Pesudomembranous Type 2 (most common) | 2. Muscular Defect Type 4 (5-20% of VSDs)

Question 30

Etiology of Membranous/Pseudomembranous VSD?

Answer 30

Deficiency of membranous septum. Tricuspid regurg or aneurysm. Blood from LV goes to RV.

Question 31

Sx of VSD?

Answer 31

Asymptomatic, SOB/DOE, fatigue.

Question 32

Murmur and sounds in VSD?

Answer 32

Holosystolic Murmur. Palpable thrill.

Question 33

PE on VSD

Answer 33

Holosystolic murmur, palbable thrill. Peds=failure to thrive HF signs: tachy, hepatomegaly, rales

Question 34

Dx in VSD?

Answer 34

2D echo w/Doppler

Question 35

CXR in VSD?

Answer 35

Cardiomegaly

Question 36

EKG in VSD?

Answer 36

Often normal. Rght, left, of biventricular hypertrophy.

Question 37

Tx in VSD depends on what?

Answer 37

Depends on size, location, and complications

Question 38

Tx for small Type 2 and 4 VSD?

Answer 38

40% close spontaneously. If not, surgial repair.

Question 39

VSD can cause what sort of hypertension? How to tx?

Answer 39

Pulmonary HTN. Meds for vasodilation.

Question 40

Which gender develops a Patent Ductus Arteriosus most often

Answer 40

Women, 2:1.

Question 41

Risk factors for PDA?

Answer 41

Premature birth, congenital rubella, FHx, congenital disorders

Question 42

PDA shunts from where to where? Cyanotic?

Answer 42

Shunts blood from aorta to left pulmonary artery. Non-cyanotic.

Question 43

Sx of PDA?

Answer 43

Usually Asx.

Question 44

Murmur and sounds in PDA?

Answer 44

Continuous machine-like murmur. Thrill in upper right chest.

Question 45

Pulse pressure with BP in PDA?

Answer 45

Widended pulse pressure with decreased DBP.

Question 46

Dx in PDA?

Answer 46

2D Echo w/Doppler CXR= normal or cardiomegaly EKG= normal of LVH

Question 47

Tx for PDA if premature babies?

Answer 47

Indomethacin or Ibuprofen. Prostaglandin-ihibitor can help close PDA.

Question 48

Tx for PDA if meds don't work?

Answer 48

Surgical ligation, transcath closure.

Question 49

pick up at coart of aorta

Answer 49

pick up at coart of aorta