Other Acyanotic Heart Defects (1) Flashcards
What type of shunt forms here?
What can happen in these types of defects?
→ What is this called?
➊ Left-to-right shunt
➋ Can become Cyanotic if the pulmonary pressure becomes higher than the systemic pressure
→ Eisenmenger Syndrome
Ventricular Septal Defect:
What occurs here?
What is it commonly associated with?
What is a complication that can occur here?
→ How does this happen?
➊ L-R shunt, leading to R-sided overload, and RHF
➋ Down’s syndrome and Turner’s syndrome
➌ Eisenmenger Syndrome
→ The increased pressure in the pulmonary vessels leads to Pulmonary HTN – As it gets more severe, it turns into a R-L shunt instead, in which the baby will become Cyanotic
How does it present?
What is heard O/E?
How is it managed?
➊ • Often asymptomatic if small
• If large:
‣ SOBOE e.g. breastfeeding
‣ Increased WOB
‣ Poor feeding
‣ Failure to thrive
• HF if heart decompensates in undetected cases
➋ Pan-systolic murmur
➌ • Often close spontaneously
• Surgical repair – Transvenous catheter closure or open-heart surgery
Atrial Septal Defect:
What are the types?
What are the complications that can occur with these?
➊ • Patent foramen ovale
• Ostium secundum – Septum secundum fails to close
• Ostium primum – Septum primum fails to close – Tends to lead to AV valve defect
➋ • Stroke – Embolism passes from R to L side
• AF
• Pulmonary HTN and RHF
• Eisenmenger Syndrome
How does it present?
What is heard O/E?
→ Why does this change in heart sound occur?
How is it managed?
➊ Same as a VSD
➋ Ejection-systolic murmur with a fixed, split, second heart sound (aortic and pulmonary valves close at slightly different times)
→ Split heart sound occurs as blood flows from LA → RA, therefore increasing the volume of blood the RV has to eject before the pulmonary valve can close
➌ • Surgical repair - Transvenous catheter closure or open-heart surgery
• Anticoagulation in adults
Aortic Coarctation:
What occurs here?
What is it often associated with?
➊ Narrowing of the aortic arch, usually just before the DA
➋ Turner’s syndrome (5%)
What is often the only presenting feature in neonates?
How does it present?
→ What is it therefore important to check?
What is heard O/E?
Over time, what may the pt develop?
How is it managed?
➊ Weak femoral pulse
➋ • Radio-femoral delay – Or radio-radial delay depending on the site and severity of the coarctation
• HF
• HTN
• Poor feeding
→ 4 limb BP
➌ Systolic murmur
➍ • LVH
• Underdeveloped left arm and legs due to the reduced blood flow
➎ • Echo for monitoring
• Neonates in a critical condition given Prostaglandins to keep the DA patent
• Surgical repair
