Term
|
Definition
1. Ostium Secundum - central interatrial septum
2. Ostium primum - low in septum
3. Sinus venous defects- high in septum |
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Term
| Pathology of Atrial Septal Defect |
|
Definition
-Oxygenated blood from LA --> RA
-Increased right heart output/ pulm blood flow
- Inc. work right side
-As shunt inc. in size, Right side dilates
-Pulm HTN rare but serious |
|
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Term
| Presentation of Atrial Septal Defect |
|
Definition
1. Mild systolic ejection murmur over pulm area, inc. pulm BFlow
2. Wide, fixed splitting of S2
3. Diastolic flow "rumble" murmur tricuspic
-RVF may be seen in advanced dz |
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Term
|
Definition
1. Ostium Secundum - central interatrial septum
2. Ostium primum - low in septum
3. Sinus venous defects- high in septum |
|
|
Term
| Pathology of Atrial Septal Defect |
|
Definition
-Oxygenated blood from LA --> RA
-Increased right heart output/ pulm blood flow
- Inc. work right side
-As shunt inc. in size, Right side dilates
-Pulm HTN rare but serious |
|
|
Term
| Presentation of Atrial Septal Defect |
|
Definition
1. Mild systolic ejection murmur over pulm area, inc. pulm BFlow
2. Wide, fixed splitting of S2
3. Diastolic flow "rumble" murmur tricuspic
-RVF may be seen in advanced dz |
|
|
Term
|
Definition
TEE- diagnostic
-CXR- large pulm arteries
-Echo w/ contrast - inject microbubbles and see cross via right -left shunt
-ECG- RBBB and Righ Axis Deviation, Afib or A-flutter |
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|
Term
| complications of Atrial Septal Defect |
|
Definition
-Einsenmenger's Disease- irreversible pulm HTN, shunt, heat failure
-Right Heart Failure
-Atrial Arrhythmias
-Stoke |
|
|
Term
|
Definition
-Most do not require closure
-If very large or symptomatic, Sx repair |
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|
Term
| Ventricular Septal Defect |
|
Definition
-Most common congenital cardiac malformation
-Blood flows from LV --> RV through hole |
|
|
Term
| Pathology of Ventricular Septal Defect |
|
Definition
-Inc. Pulm blood flow, shunt left to right b/c PulmVR< SystemicVR
-If PVR increases, shunt reverses
-Large defect = Pulm HTN |
|
|
Term
|
Definition
-small shunt asymptomatic
-large w/o elevated PVR = CHF, growth abnormalities, lower respiratory infections
-Large shunt w. high PVR (Eisenmenger's) : SOB, dyspnea w/ exertion, chest pain, syncope, cyanosis |
|
|
Term
|
Definition
-Harsh, blowing holosystolic murmur w. thrill at 4th intercostal space
-Dec. murmur w. valsalva and handgrip
-Smaller defect = louder murmur
-Sternal lift from RV enlargement
-S2 inc. in intensity as PVR increases |
|
|
Term
| Ventricular Septal Defect |
|
Definition
-Most common congenital cardiac malformation
-Blood flows from LV --> RV through hole |
|
|
Term
| Pathology of Ventricular Septal Defect |
|
Definition
-Inc. Pulm blood flow, shunt left to right b/c PulmVR< SystemicVR
-If PVR increases, shunt reverses
-Large defect = Pulm HTN |
|
|
Term
|
Definition
-small shunt asymptomatic
-large w/o elevated PVR = CHF, growth abnormalities, lower respiratory infections
-Large shunt w. high PVR (Eisenmenger's) : SOB, dyspnea w/ exertion, chest pain, syncope, cyanosis |
|
|
Term
|
Definition
-Harsh, blowing holosystolic murmur w. thrill at 4th intercostal space
-Dec. murmur w. valsalva and handgrip
-Smaller defect = louder murmur
-Sternal lift from RV enlargement
-S2 inc. in intensity as PVR increases |
|
|
Term
| Ventricular Septal Defect |
|
Definition
-Most common congenital cardiac malformation
-Blood flows from LV --> RV through hole |
|
|
Term
| Pathology of Ventricular Septal Defect |
|
Definition
-Inc. Pulm blood flow, shunt left to right b/c PulmVR< SystemicVR
-If PVR increases, shunt reverses
-Large defect = Pulm HTN |
|
|
Term
|
Definition
-small shunt asymptomatic
-large w/o elevated PVR = CHF, growth abnormalities, lower respiratory infections
-Large shunt w. high PVR (Eisenmenger's) : SOB, dyspnea w/ exertion, chest pain, syncope, cyanosis |
|
|
Term
|
Definition
-Harsh, blowing holosystolic murmur w. thrill at 4th intercostal space
-Dec. murmur w. valsalva and handgrip
-Smaller defect = louder murmur
-Sternal lift from RV enlargement
-S2 inc. in intensity as PVR increases |
|
|
Term
|
Definition
-ECG- biventricular hypertrophy in pts w/ high PulmVR
-CXR - enlarged pulm arteries, enlarged cardiac silhouette
as PVR inc. heart size dec.
-Echo - see septal defect |
|
|
Term
|
Definition
1. Endocarditis
2. Aortic Regurge
3. Heart Failure
4. Pulm HTN and shunt reversal |
|
|
Term
|
Definition
1. Asymptomatic w/ small defect, monitor
2. Sx repair if Pulm flow:systemic flow ratio >1.5:1 |
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|
Term
| What is coarctation of aorta? |
|
Definition
| Narrowing/constriciton of aorta (usually left subclavian origin), leads to obstruction btw proximal and distal aorta = Inc. Left ventricle afterload |
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Term
| Presentation of Coarctation of Aorta |
|
Definition
-HTN in UE w. hypotension in LE
-Upper body well developed, lower body under-developed
-High prevalence in Turner's syndrome |
|
|
Term
| Signs and S of Coarctation A |
|
Definition
-Headache, cold extremeties, claudication w. exercise, leg fatigue
-Delayed femoral pulses compared to radial |
|
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Term
|
Definition
1. ECG - LVH
2. CXR -notching of ribs
-Figure 3 appearance |
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|
Term
| Complications of Coarctation of A |
|
Definition
-Severe HTN
-Rupture of cerebral aneurysm
-Infective endocarditis
-Aortic dissection |
|
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Term
|
Definition
-Sx decompression
-Percutaneous ballon aortoplasty in some cases |
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|
Term
| What is Patent Ductus Arteriosus |
|
Definition
-Communication btw aorta and pulm artery after birth
-Normally closes within days after birth
-Left to Right shunt if remains |
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|
Term
| What keeps PDA in fetal life |
|
Definition
prostaglandins and low oxygen tension keep open
-blood is shunted away from nonfunctioning lungs |
|
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Term
|
Definition
Rubella syndrome
High altitude
Premature birth |
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|
Term
|
Definition
-Large Left-right shunt : volume overload, pulm HTN, right-side heart failure
-late cyanosis
-can see reversal of blood flow |
|
|
Term
|
Definition
-Asymptomatic
-Signs right heart fail
-Loud P2- pulm HTN
-LVH- secondary to shunt
-RVH - secondary to pulm HTN
-Machinery murmur
-Wide pulse pressure, bounding peripheral pulses
-clubbing - toes especially |
|
|
Term
|
Definition
1. CXR - Inc pulm vascular markings
-dilated pulm artery
-enlarged cardiac silhouette
-calcification of ductus arteriosus sometimes
2. Echo -turbulent blood flow and patent ductus |
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|
Term
| Tx PDA- w/o pulm vascular dz |
|
Definition
|
|
Term
| Tx PDA w. severe Pulm HTN or right-left shunt |
|
Definition
Surgery contraindicated
-Indomethacin for closure, Prostaglandin E |
|
|
Term
| What is Tetralogy of Fallot |
|
Definition
Triad of cardiac abnormalities:
1. Ventricular septal defect
2. RVH
3. Pulm artery stenosis and
4. overriding aorta
-Defect in development of infundibular septum |
|
|
Term
| Presentation of Tetralogy of Fallot |
|
Definition
-Cyanosis- most common
-Tet spells - squat after exertion or crying spell to inc. SVR to shunt blood to lungs instead of aorta
-Crescendo-decrescendo murmur |
|
|
Term
|
Definition
1. Echo- best, defines 4 abnormalities clearly
2. EKG- may show enlarged RA and RV
3. CXR- classic "boot shaped heart"
4. Cardiac cath - to fully define anatomy |
|
|
Term
|
Definition
1. May need Oxygen, morphine, B-blocker if pt cyanotic
2. Surgical- w/in 1st of life |
|
|
Term
| What is Tetralogy of Fallot |
|
Definition
Triad of cardiac abnormalities:
1. Ventricular septal defect
2. RVH
3. Pulm artery stenosis and
4. overriding aorta
-Defect in development of infundibular septum |
|
|
Term
| Presentation of Tetralogy of Fallot |
|
Definition
-Cyanosis- most common
-Tet spells - squat after exertion or crying spell to inc. SVR to shunt blood to lungs instead of aorta
-Crescendo-decrescendo murmur |
|
|
Term
|
Definition
1. Echo- best, defines 4 abnormalities clearly
2. EKG- may show enlarged RA and RV
3. CXR- classic "boot shaped heart"
4. Cardiac cath - to fully define anatomy |
|
|
Term
|
Definition
1. May need Oxygen, morphine, B-blocker if pt cyanotic
2. Surgical- w/in 1st of life |
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