L4: Acyanotic Heart Diseases - PDA & ASD Flashcards
(82 cards)
1
Q
Incidence of PDA
A
2
Q
Anatomy of PDA
A
3
Q
Pathophysiology of PDA
A
4
Q
Pathophysiology of PDA
The extent of the shunt depends on:
A
5
Q
There is a wide pulse pressure (due to runoff of blood into PA during diastole)
A
….
6
Q
Why isolated large PDA is not a cause of heart failure in neonates?
A
7
Q
Symptoms of Small PDA
A
Asymptomatic
8
Q
Signs of Small PDA
A
9
Q
Signs of Small PDA
- Inspection & Palpation
A
10
Q
Signs of Small PDA
- Precordial Bulge
A
Normal
11
Q
Signs of Small PDA
- Precordial Activity
A
Normal
12
Q
Signs of Small PDA
- Apex
A
13
Q
Signs of Small PDA
- Pulsation
A
- 2nd left space
- Radiate to: 2nd left clavicle - left parasternal border - apex
14
Q
Signs of Small PDA
- Thrill
A
Continous
15
Q
Signs of Small PDA
- Auscultation
A
16
Q
Signs of Small PDA
- Heart Sounds
A
Normal
17
Q
Signs of Small PDA
- Murmur
A
18
Q
Murmur in Small PDA
- Site
A
2nd Left intercostal space “pulmonary area”
19
Q
Murmur in Small PDA
- Characters
A
Machinery or rolling thunder murmur (Gibson’s murmur)
20
Q
Murmur in Small PDA
- Radiation
A
Down the left sternal border or to the left clavicle
21
Q
Murmur in Small PDA
- Timing
A
- Continuous
- Reaches maximal intensity at end of systole & Wanes in late diastole
22
Q
Murmur in Small PDA
- If Increased PVR —> Decreased Diastolic component or may disappear
A
…
23
Q
Murmur in Small PDA
- Others
A
24
Q
Complications of Small PDA
A
25
Investigations for **Small PDA**
26
Investigations for **Small PDA**
- Chest X-Ray
Normal
27
Investigations for **Small PDA**
- ECG
Normal
28
Investigations for **Small PDA**
- ECHO
Normal
29
Investigations for **Small PDA**
- Catheter
30
TTT of **Small PDA**
31
Prognosis of **Small PDA**
Mortality < 1%
32
Symptoms of **Large PDA**
- Heart failure
- FTT
- Growth restriction
33
Signs of **Large PDA**
34
Signs of **Large PDA**
- General
- Water hammer pulse = Bounding pulse = wide pulse pressure
35
Signs of **Large PDA**
- Inspection & Palpation
36
Signs of **Large PDA**
- Precordial Bulge
36
Signs of **Large PDA**
- Precordial Activity
Active
36
Signs of **Large PDA**
- Apex
36
Signs of **Large PDA**
- Pulsation
- 2nd left space
- Radiate to: left clavicle - left parasternal border - apex
36
Signs of **Large PDA**
- Thrill
Continous
37
Signs of **Large PDA**
- Auscultation
38
Signs of **Large PDA**
- Heart Sounds
Normal
39
Signs of **Large PDA**
- Murmur
40
Murmur in **Large PDA**
41
Murmur in **Large PDA**
- Site
2nd Left intercostal space "pulmonary area"
42
Murmur in **Large PDA**
- Characters
Machinery or rolling thunder murmur (Gibson's murmur)
43
Murmur in **Large PDA**
- Radiation
Down the left sternal border or to the left clavicle
44
Murmur in **Large PDA**
- Timing
- Continuous
- Reaches maximal intensity at end of systole & Wanes in late diastole
45
Murmur in **Large PDA**
- If increased PVR ---> Decreased Diastolic component or may disappear
...
46
Murmur in **Large PDA**
- Others
47
Complications of **Large PDA**
48
Investigations of **Large PDA**
49
Investigations of **Large PDA**
- Chest X-Ray
- Prominent pulmonary artery
- Increased PVM
- LAE & LVE
- Normal / Prominent aortic knob
50
Investigations of **Large PDA**
- ECG
LVE +- RVE
51
Investigations of **Large PDA**
- ECHO
* LAE & LVE
* Direct visualization of PDA
52
Investigations of **Large PDA**
- Catheter
53
TTT of **Large PDA**
54
Prognosis of **Large PDA**
Mortality < 1%
55
Incidence of **ASD**
6 - 8% of congenital heart disease
56
Types of **ASD**
57
Types of **ASD**
- Most Common
Secundum ASD
58
Pathophysiology of **ASD**
- Post-Natal Physiology
- Adaptive Mechanisms
59
Pathophysiology of **ASD**
- Post-Natal Physiology
60
Pathophysiology of **ASD**
- Adaptive Mechanisms
61
CP of **ASD**
- Symptoms (Large)
- Signs
62
CP of **ASD**
- Symptoms (Large)
63
Signs of **ASD**
64
Signs of **ASD**
- Inspection & Palpation
65
Signs of **ASD**
- Auscultation
66
- Diastolic murmur of tricuspid stenosis is similar to that of mitral stenosis
- Except that it's heard best at the left lateral sternal border and may radiate to the apex or xiphoid.
...
67
Small ASD is asymptomatic and there are no significant findings on auscultation.
...
68
Investigations for **ASD**
69
Investigations for **ASD**
- Chest X-Ray
70
Investigations for **ASD**
- ECG
- RT axis deviation
- RAE & RVE
- rsR' Pattern on V1
71
Investigations for **ASD**
- ECHO
Same as VSD
72
Investigations for **ASD**
- Catheter
Indications:
- Atypical finding
- Trans-catheter closure (therapeutic)
73
Complications of **ASD**
74
Managmenet of **ASD**
75
Management of **ASD**
- Medical
76
Management of **ASD**
- Surgical
77
Prognosis of **ASD**
- Once pulmonary HTN occur, shunt reversal occurs (that is too late)
- Mortality < 1%.
78
Done
..
