L4: Acyanotic Heart Diseases - Obstructive Lesions Flashcards
(65 cards)
1
Q
Incidence of Aortic Stenosis
A
- 4 - 5 of CHD
- Males > Females
2
Q
Types of Aortic Stenosis
A
© Valvular stenosis.
© Supravalvular stenosis (Williams’ syndrome)
© Discrete subaortic stenosis
© Idiopathic hypertrophic subaortic stenosis (IHSS)
3
Q
Pathology of Aortic Stenosis
A
4
Q
Pathophysiology of Aortic Stenosis
A
5
Q
Symptoms of Aortic Stenosis
A
6
Q
Signs of Aortic Stenosis
A
7
Q
Signs of Aortic Stenosis
- General
A
8
Q
Signs of Aortic Stenosis
- Inspection & Palpation
A
9
Q
Signs of Aortic Stenosis
- Auscultation
A
10
Q
Murmur in Aortic Stenosis
- Site
- Character
- Grade
- Radiation
- Timing
- Other Murmur
A
11
Q
Investigations for Aortic Stenosis
A
12
Q
Investigations for Aortic Stenosis
- Chest X-Ray
A
13
Q
Investigations for Aortic Stenosis
- ECG
A
14
Q
Investigations for Aortic Stenosis
- ECHO
A
15
Q
Complications of Aortic Stenosis
A
- Infective endocarditis.
- Arrhythmias.
- Sudden death.
- HF in critical AS or very late
16
Q
TTT of Aortic Stenosis
A
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
18
Q
Incidence of Pulmonary Stenosis
A
8 - 12 % of CHD
19
Q
Types of Pulmonary Stenosis
A
- Valvular stenosis.
- Infravalvular stenosis
- Supravalvular PS (or stenosis of the MPA)
20
Q
Pathophsyiology of Pulmonary Stenosis
A
21
Q
Symptoms of Pulmonary Stenosis
A
22
Q
Signs of Pulmonary Stenosis
A
23
Q
Signs of Pulmonary Stenosis
- General
A
24
Q
Signs of Pulmonary Stenosis
- Inspection & Palpation
A
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 ......
