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OB 2 > Normal and Abnormal Fetal Heart > Flashcards

Normal and Abnormal Fetal Heart Flashcards

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1
Q

At how many weeks does the heart start to circulate?

A

5 weeks

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2
Q

When do structures fuse to form a single heart tube?

A

22 days

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3
Q

What structures separate the atria and ventricles and when do they begin to develop?

A

Endocardial cushions
27 days

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4
Q

What does the septum primum divide?

A

L and R atria

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5
Q

When is the aorticopulmonary septum formed?

A

7th week

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6
Q

When has the heart completed formation?

A

8th week

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7
Q

The UV shunts blood into what structure?

A

Ductus venosus –> IVC

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8
Q

Through what valve does blood pass to enter the foramen ovale –> LA

A

Eustachian valve

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9
Q

Where does blood go coming from the IVC versus coming from the SVC?

A

IVC –> eustachian valve –> foramen ovale –> LA

SVC –> TV –> RV –> PV –> ductus arteriosus –> aortic and systemic circulation

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10
Q

Where is the more highly oxygenated blood shunted to from the aorta?

A

Cranial portion

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11
Q

Blood in the LA is contributed by what structures?

A

Pulmonary veins and from RA through the foramen ovale

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12
Q

How to tell what side of the heart is which in a TRV view?

A

L side is closer to the spine

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13
Q

What is the term for the normal angle of the heart?

A

Levocardia

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14
Q

What typically oocurs to the heart within the chest when there is a mass lesion seen in the thoracic cavity?

A

Dextroposition and mesocardia

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15
Q

What is the term for the heart on the right side but apex is pointing to the left?

A

Dextroposition

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16
Q

In the fetal heart, will the RV or LV appear slightly larger?

A

RV

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17
Q

What structure should the foraminal flap open into?

A

LA

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18
Q

What structures does the ductal arch view encompass?

A

Pulmonary artery
Ductus arteriosus
Desc Ao

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19
Q

What valves can you see in SAX of the fetal heart?

A

PV
TV
Ao V

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20
Q

What structures encompass the aortic arch?

A
  1. Brachiocephalic A
  2. LCCA
  3. L subclavian A
  4. Desc Ao
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21
Q

What is the smallest vessel in the 3VV?

A

SVC

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22
Q

What is the most common benign fetal arrhythmia?

A

PAC

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23
Q

What is a non-conducted PAC?

A

Stops at the AV node

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24
Q

bpm in SVT?
Ratio of atrial to ventricular contractions?

A

180-300bpm
1:1

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25
What heart rate is considered tachycardia in the fetus?
>180
26
What heart rate is considered bradycardia in a fetus?
<100
27
A fetus that does not respond to treatment of SVT is at risk for what two things?
Heart failure and non-immune hydrops
28
What arrythmia is between 300-400bpm and has a 2:1 ratio of atrial to ventricular beats?
Atrial flutter
29
What arrythmia does not have a set atrial or ventricular contraction rate?
A-fib >400bpm
30
What heart abnormality has a normal atrial rate and slower ventricular rate? A) 1st degree HB B) 2nd degree HB C) 3rd degree HB D) Atrial flutter
3rd degree heart block
31
What is the term for a bradycardic rate that comes and goes?
Transient Bradycardia
32
What are the most common cardiac malformations?
VSD's
33
In what heart abnormality is it common to see VSD's?
TOF
34
What are the four types of VSD's?
1. Inlet - close to the TV's- can detect in 4Ch view 2. Outlet - most superior and close to the AoV and PV 3. Trabecular AKA midmuscular or central 4. Apical - Past the insertion point of the moderator band
35
Most common types of ASD's in order?
1. Ostium secundum - m/c 2. Ostium primum 3. Sinus venosus
36
Which ASD is most commonly associated with a AV defect?
Ostium primum as it is right next to the IVS
37
In what abnormality will result in fetal death without the presence of an ASD?
Transposition of the great vessels
38
What are AVSD's also called?
AV canal or endocardial cushion defect
39
What heart abnormality is associated with all trisomies?
AVSD's
40
What is the most common severe left sided obstructive lesion?
Hypoplastic L heart syndrome
41
What heart defect is the most common cause of death or stillbirth?
Hypoplastic L heart syndrome
42
What abnormality may not present until 2nd trimester?
hypoplastic L heart syndrome
42
What findings in the 2nd trimester is suspicious of hypoplastic L heart syndrome?
Mitral stenosis
43
What does RV hypoplasia generally result from?
Pulmonary atresia but can also occur due to tricuspid atresia
44
What heart abnormality is seen with a ductal-dependent lesion?
RV hypoplasia
45
What is a progressive lesion that tends to worsen as pregnancy continues?
Tricuspid atresia
46
What are the most common sites for Aortic coarctation?
Ductal and postductal
47
Describe types A, B, and C of aortic coarctaction?
A: distal to Lsubclavian artery B: b/w L subclavian and LCCA C: b/w LCCA and brachiocephalic trunk
48
Visualization of a larger RV without any other abnormalities is suspicious of what?
Aortic coarctation
49
What abnormality is associated with aortic coarctation?
Bicuspid Ao valve
50
What is the most common form of cyanotic heart disease?
TOF
51
Classic features of TOF? (4)
1. Perimembranous VSD 2. Overriding aorta 3. Pulmonary atresia 4. RV hypertrophy
52
3 types of PA abnormalities with TOF
1. Pulmonary stenosis 2. Pulmonary atresia with patent ductus 3. Pulmonary atresia with aortopulmonary collaterals
53
What abnormality causes a larger RA and smaller RV?
Ebstein Anomaly due to the TV being displaced far down in the RV
54
What measurement between MV and TV is likely to diagnose ebstein anomaly?
>8mm
55
What anomaly is associated with maternal ingestion of lithium carbonate?
Ebstein anomaly
56
In complete transposition, where is the Ao in relation to the PA?
Ao is to the right
57
In what TGA are the RA and RV concordant?
Complete transposition - RA connects to RV which connects to Ao LA connects to LV which connects to PA
58
T or F? Complete TGA is more common than incomplete TGA
True
59
What are the connections in the heart with incomplete TGA?
RA connects to LV which connects to PA LA connects to RV which connect to Ao
60
Why does truncus arteriosis occur?
Failure of the pulmonary and aortic trunks to fuse
61
What chambers does the truncus arteriosis receive blood from?
LV and RV
62
What is the most common type of DORV?
DORV with a subaortic VSD
63
Where is the VSD in a VSD type DORV?
Below the aorta
64
Where is the VSD in a TGA type DORV?
Below the pulmonary artery
65
Where is the VSD in a Fallot type?
Doubly-commited meaning there is a VSD below both the PA and Ao and pulmonary stenosis
66
Where is the VSD in a non-committed DORV?
VSD is in a remote location
67
What two cardiac abnormalities will you see the Ao and PA running in parallel rather than crossing over?
1. TGA 2. DORV
68
A strong association of poorly controlled diabetes has contributed to what heart abnormality?
DORV
69
What is the most common fetal cardiac tumour?
Rhabdomyoma
70
What arrythmia is most commonly seen with a fetal rhabdomyoma?
SVT
71
The normal aorta should be seen crossing over the PA in which orientation? A) Posteriorly B) Anteriorly C) Laterally D) Medially
Anteriorly
72
How do you obtain the 3VV from a 4CH?
Move transducer cephalad
73
You see a defect near the SVC, what type of ASD is it?
Sinus venosus

OB 2 (20 decks)

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