The pathophysiology of congenital heart disease Flashcards Preview

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Flashcards in The pathophysiology of congenital heart disease Deck (23):
1

What are the 3 general etiologies of CHD?

87% of the etiology of CHD is _____.

1. genetic
2. environmental (drugs, chemicals, viruses, maternal disease)
3. mutifactoral: combo of gen and enviro (myocarditis that progresses)

87% = multifactorial

2

What are the common genetic syndromes are assc with also having of CHD?

down syndrome (50%)
turners (20%)
marfan (60%)
trisomy 18 (90%)
trisomy 13 (80%)
DiGeorge (80%)
Noonan
WIlliams

3

What are the common environmental factors for the development of CHD?

1. infections (Rubella in baby)
2. Diseases (PKU in baby, DM in mom)
3. drugs (thalidomide, dilantin, trimethadione, psychoprophics)
4. toxins (alcohol)

4

How does fetal circualtion determine cardiac development

dec flow to the right side --> small right sided structures

dec flow to left -->

5

At birth, how does the babys circualtion change? (normal) what would happen in pulmonary HTNN

systemic resistance increases
pulmonary resistance decreases

pulmonary vasular resistance=
1/2 of systemic after 24 hrs
may take 2-6 weeks to develop adult levels

dec Q to LV --> organ failure

6

closure of ductus arteriosis and ductus venous occurs in ___ (time)

days

7

closure of formamen ovale occurs in ____ (time)

weeks to months

8

ventricular septal defect: what does the echo show as the child gets older?

initially no hypertrophy

2wk-2mo: LVH

1-2 yrs: RVH

9

ventricular septal defect: how does pulmonary flow change as the child gets older?

initially: nml

2wk-2mo: increased pulmonary flow (because pulm resistance is less than systemic resistance)

1-2 years: decreased pulmonary flow

10

When will a child with VSD begin to appear cyanotic?

~1-2 years (related to pulmonary resistance??)

11

Physiologic/innocent murmurs are never...

diastolic
associated with a thrill

12

Murmurs: In AV valves, regurgitation is heard during (systole/diastole) and stenosis is heard during (systole/diastole).

systole
diastole

13

Murmurs: In semilunar valves, regurgitation is heard during (systole/diastole) and stenosis is heard during (systole/diastole).

diastole
systole

14

Atrial septal defects have murmurs of relative stenosis of (which valves)?

pulmonary stenosis
tricuspid stenosis

(is this WTF all of her letters meant?)

15

Ventricle septal defects and AV canal defects have murmurs of relative stenosis of (which valve)?

mitral stenosis

16

Most common congenital heart defect? Then what?

ventr septal defect
transposition of great arteries

17

Cyanosis occurs when there is a desaturated concentration of hgb greater than...

4

18

Cyanosis may be caused by

central apnea
pneumonia/pneumothorax
shunting
some heart defects

19

Hypoplastic left heart syndrome presents with what abn on echo? Is this a cyanotic or non-cyanotic defect?

small LV with very low volume

cyanotic

20

What are the cyanotic congenital heart defects?

I Truncus Arteriosus
II Transposition of Gr Arteries
III Tricuspid Atresia
IV Tetralogy of Fallot
V Total Anomalous Pulmonary Venous Return

Mnemonic: 1 trunk, 2 arteries; tri = 3; tetr = 4; 5 = 5 words

21

In Total Anomalous Pulmonary Venous Return, the blood mixes in the:

RA

22

An unrestrictive VSD in a newborn infant is likely to be associated with little or no:

murmur
(it takes ~2 mo for the pulm resistance to fall)

23

Systolic murmur in left upper sternal border in a patient with an ASD is caused by:

relative pulmonary stenosis from increased pulmonary flow