L4: Acyanotic Heart Diseases - Obstructive Lesions Flashcards

(65 cards)

1
Q

Incidence of Aortic Stenosis

A
  • 4 - 5 of CHD
  • Males > Females
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2
Q

Types of Aortic Stenosis

A

© Valvular stenosis.
© Supravalvular stenosis (Williams’ syndrome)
© Discrete subaortic stenosis
© Idiopathic hypertrophic subaortic stenosis (IHSS)

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3
Q

Pathology of Aortic Stenosis

A
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4
Q

Pathophysiology of Aortic Stenosis

A
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5
Q

Symptoms of Aortic Stenosis

A
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6
Q

Signs of Aortic Stenosis

A
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7
Q

Signs of Aortic Stenosis

  • General
A
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8
Q

Signs of Aortic Stenosis

  • Inspection & Palpation
A
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9
Q

Signs of Aortic Stenosis

  • Auscultation
A
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10
Q

Murmur in Aortic Stenosis

  • Site
  • Character
  • Grade
  • Radiation
  • Timing
  • Other Murmur
A
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11
Q

Investigations for Aortic Stenosis

A
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12
Q

Investigations for Aortic Stenosis

  • Chest X-Ray
A
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13
Q

Investigations for Aortic Stenosis

  • ECG
A
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14
Q

Investigations for Aortic Stenosis

  • ECHO
A
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15
Q

Complications of Aortic Stenosis

A
  • Infective endocarditis.
  • Arrhythmias.
  • Sudden death.
  • HF in critical AS or very late
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16
Q

TTT of Aortic Stenosis

A
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17
Q

TTT of Aortic Stenosis

  • Indications of balloon valvuloplasty
A
  • Asymptomatic patient with MPG > 50 with T wave changes.
  • Symptomatic patient with MPG > 50 mmHg
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18
Q

Incidence of Pulmonary Stenosis

A

8 - 12 % of CHD

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19
Q

Types of Pulmonary Stenosis

A
  • Valvular stenosis.
  • Infravalvular stenosis
  • Supravalvular PS (or stenosis of the MPA)
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20
Q

Pathophsyiology of Pulmonary Stenosis

A
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21
Q

Symptoms of Pulmonary Stenosis

A
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22
Q

Signs of Pulmonary Stenosis

A
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23
Q

Signs of Pulmonary Stenosis

  • General
A
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24
Q

Signs of Pulmonary Stenosis

  • Inspection & Palpation
A
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25
Signs of **Pulmonary Stenosis** - Auscultation
26
Signs of **Pulmonary Stenosis** - Heart Sounds
27
Signs of **Pulmonary Stenosis** - Murmur
28
Murmur in **Pulmonary Stenosis** - Site - Grade - Radiation - Timing - Notes
29
INVx for **Pulmonary Stenosis**
30
INVx for **Pulmonary Stenosis** - Chest X-Ray
31
INVx for **Pulmonary Stenosis** - ECG
- Right axis deviation - RVH in moderate PS (the degree of RVH depends on the severity of PS)
32
INVx for **Pulmonary Stenosis** - ECHO
To assess the degree of the valve stenosis
33
Complications of **Pulmonary Stenosis**
- CHF may develop in patients with severe stenosis. - Sudden death is possible in patients with severe stenosis during heavy physical activities.
34
TTT of **Pulmonary Stenosis**
35
Natural History & Prognosis of **Pulmonary Stenosis**
36
Prevelance of **Coartication of Aorta**
37
Etiology of **Coartication of Aorta**
38
Pathology of **Coartication of Aorta**
39
Pathology of **Coartication of Aorta** - Post-Ductal
40
Pathology of **Coartication of Aorta** - Pre-Ductal
41
Pathogenesis of **Coartication of Aorta**
42
Pathogenesis of **Coartication of Aorta** - In Utero
43
Pathogenesis of **Coartication of Aorta** - Neonatal Period
44
Pathogenesis of **Coartication of Aorta** - At Birth
45
Pathogenesis of **Coartication of Aorta** - Compensatory Mechanisms
45
CP of **Coartication of Aorta**
- Symptoms & Signs
46
Symptoms of **Coartication of Aorta**
47
Symptoms of **Coartication of Aorta** - Newborn with severe COA
- Poor perfusion - CHF - Acidemia - Deferential cyanosis. - Shock
48
Symptoms of **Coartication of Aorta** - Deferntial Cyanosis
- O2 saturation measured in the right arm (preductal) is > in the leg (post-ductal) due to right-to-left shunting across the PDA into the descending thoracic aorta.
49
Signs of **Coartication of Aorta**
50
Signs of **Coartication of Aorta** - General
51
Signs of **Coartication of Aorta** - Auscultation
52
Signs of **Coartication of Aorta** - Heart Sounds
S2 ---> single & accentuated
53
Signs of **Coartication of Aorta** - Murmur
* 50% -----> No murmur * 50% ----> Non-specific ejection systolic murmur over the precordium * The heart murmur may become louder after treatment
54
Investigations for **Coartication of Aorta**
55
Investigations for **Coartication of Aorta** - Chest X-Ray
56
Investigations for **Coartication of Aorta** - ECG
* A normal or right axis deviation * RVH or right bundle branch block (RBBB) are present rather than LVH. * LVH is seen in older children
57
Investigations for **Coartication of Aorta** - ECHO
2D echo and color flow Doppler studies usually show: - Site of the coarctation - Extent of the coarctation.
58
Investigations for **Coartication of Aorta** - MSCT
...
59
Natural History of **Coartication of Aorta**
60
TTT of **Coartication of Aorta**
61
TTT of **Coartication of Aorta** - Medical
62
TTT of **Coartication of Aorta** - Surgical
63
TTT of **Coartication of Aorta** - Balloon Angioplasty
64
In asymptomatic patients, medical management may be ......