Term
| 3 types of atrial septal defects: |
|
Definition
1. secundum
2. primum
3. sinus venosus |
|
|
Term
| which of the 3 types of ASDs is the most common? |
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Definition
|
|
Term
| more common in males or females? |
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Definition
|
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Term
| most defects less than __mm will spontaneously close. |
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Definition
|
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Term
| whay is a Patent Foramen Ovale not considered an ASD (atrial septal defect)? |
|
Definition
| bc non septal tissue is missing |
|
|
Term
| what % of normal adults have a patent foramen ovale (PFO)? |
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Definition
|
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Term
| as long as ____ atrial pressure exceeds _____ atrial pressure no interatrial shunting will occur. |
|
Definition
| left should exceed right to keep the flap closed |
|
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Term
|
Definition
| asymptomatic unless it is large, then: failure to thrive, recurrent resp infections, heart failure |
|
|
Term
| how are ASDs usually discovered? |
|
Definition
|
|
Term
| what is heard on auscultation of an ASD? |
|
Definition
| systolic ejection murmur, splitting of the second heart sound, tachycardia |
|
|
Term
|
Definition
| RAD, prolonged PR interval |
|
|
Term
|
Definition
| cariac enlargement and increased pulmonary vasculature |
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|
Term
| TEST Q: What is the test of choice in Dx of ASD? |
|
Definition
|
|
Term
|
Definition
most will close on their own
surgery; percutaneous transcatheter approach |
|
|
Term
| when should an adult ASD be surgically corrected? |
|
Definition
| if there are signs of RV overload |
|
|
Term
|
Definition
| asymptomatic could have exertional dyspnea, cardiac failure, loud systolic ejection murmur (split S2) |
|
|
Term
| what is the frequent cause of cryptogenic strokes in people under 55yo? |
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Definition
|
|
Term
| migrane headaches are common in people with: |
|
Definition
|
|
Term
| TEST Q: what is the most common congenital heart malformation? |
|
Definition
| Ventricular septal defect |
|
|
Term
| 4 types of ventricular septal defect: |
|
Definition
1. membraneous
2. outlet
3. inlet
4. muscular |
|
|
Term
| what is the most common site of VSD? |
|
Definition
|
|
Term
| VSD can lead to dysrrhythmias due to: |
|
Definition
| interruption of the bundle of His |
|
|
Term
| describe an outlet defect of a VSD: |
|
Definition
| affects the blood flow out of the right ventricle into the pulmonary artery |
|
|
Term
| describe inlet defect of VSD: |
|
Definition
occur at the atrioventricular canal, affects blood flow from right atrium into right venticle
Don't close spontaneously
commonly assoc w ASD |
|
|
Term
| where are muscular defects of VSDs located? |
|
Definition
| right ventricular free wall |
|
|
Term
| __% of small VSDs close spontaneously within the first 2yrs. |
|
Definition
|
|
Term
| what size VSD causes Sx wn the first weeks of life? |
|
Definition
|
|
Term
| if large VSD not repaired by _-_ months of age then it may lead to permanent : |
|
Definition
| if not repaired within 3-4months may lead to permanent pulmonary vascular damage & RVH |
|
|
Term
|
Definition
| right to left shunting of unoxygenated blood into the left ventricle caused by VSD |
|
|
Term
| TEST Q: what type of murmur is heard in a small to moderate VSD? |
|
Definition
|
|
Term
| 5 clinical findings of large defects of VSD: |
|
Definition
1. fatigue
2. frequent lung infections
3. failure to thrive
4. CHF in infancy
5. pansystolic murmur(left sternal border) |
|
|
Term
| what does EKG show in large VSD |
|
Definition
|
|
Term
| which test can determine the size and position of defect? |
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Definition
|
|
Term
| vascular connection between the main pulmonary artery and the aorta: |
|
Definition
|
|
Term
| when is the ductus ateriosis supposed to close? |
|
Definition
|
|
Term
| what chemical factors keep the ductus arteriosis open? |
|
Definition
| low O2 levels, prostaglandins from placenta |
|
|
Term
| patent ductus arteriosis can be as high as 60% in infants born before: |
|
Definition
|
|
Term
| females or males more prevalent in patent ductus ateriosis? |
|
Definition
|
|
Term
| describe the murmur for patent ductus arteriosis: |
|
Definition
| systole 3/6 or less, not affected by position |
|
|
Term
| TEST Q: 4/6 continuous MACHINE-LIKE murmur, left infraclavicular region: |
|
Definition
| Large Patent Ductus Arteriosis |
|
|
Term
| patent ductus arteriosis clinical manifestations in premature infants:5 |
|
Definition
1. apnea
2. resp distress/tachypnea
3. HF
4. Tachycardia
5. nonspecific systolic murmur or no murmur |
|
|
Term
| what is the gold standard for Dx of patent ductus arteriosis? |
|
Definition
|
|
Term
| 3 complications of patent ductus arteriosis: |
|
Definition
1. HF
2. infective endocarditis
3. Pulmonary HTN |
|
|
Term
| what is the first line therapy for patent ductus arteriosis? |
|
Definition
| Indomethacin (NSAID that reduces prostaglandin syn) |
|
|
Term
| what are the side effects of indomethacin and what is an alternative? |
|
Definition
side effects: renal dysfxn, GI toxicity
Ibuprofen is the alternative |
|
|
Term
| what is the surgical Tx for patent ductus ateriosis? |
|
Definition
|
|
Term
| if the patent ductus ateriosis is not closed the child will likely develop: |
|
Definition
| CHF, poor growth, and frquent infections |
|
|
Term
| narrowing of the thoracic aorta distal to the left subclavian artery: |
|
Definition
|
|
Term
| males or females more common in coarctation of aorta? |
|
Definition
|
|
Term
| which genetic syndrome may coarctation of aorta be assoc w? |
|
Definition
|
|
Term
| what is the leading cause of CHF in newborn? |
|
Definition
| coarctation alone or in combo w septal defect |
|
|
Term
| TEST Q: what is the major clinical manifestation of coarctation of aorta? |
|
Definition
| Decrease or Absence of femoral pulse |
|
|
Term
| which tests can confirm coarctation of aorta? |
|
Definition
|
|
Term
| 2 complications of coarctation of aorta: |
|
Definition
1. intracranial aneurysm
2. infective endocarditis |
|
|
Term
| Tx for coarctation of aorta:<6mo, 6mo-5yrs, >5yrs |
|
Definition
| neonates give prostaglandin to keep it open, must be repaired by surgery before 6mo, 6mo-5yrs may use angioplasty, >5yrs balloon angioplasty w stent placement |
|
|
Term
| what is the follow up recomendations for post surgery coarctation of aorta? |
|
Definition
| MRI 1yr after procedure and then Q 3-5yrs to eval recoarctation or aneurysm |
|
|
Term
| Adult presentation coarctation of aorta: |
|
Definition
|
|
Term
| most untreated adults die of coarctation of aorta before age __ |
|
Definition
|
|
Term
| 3 major risks for adult coarctation of aorta: |
|
Definition
1. rupture of aorta
2. cerebral hemorrhage
3. aortic dissection |
|
|
Term
congenital heart defect consisting of: 1. stenosis of pulm artery
2. VSD
3. Deviation of the origin of aorta to the right
4. concentric RVH |
|
Definition
|
|
Term
| clinical presentation of tetralogy of Fallot: 3 |
|
Definition
1. cyanosis
2. harsh systolic murmur
3. TET SPELLS - acute cyanosis,dyspnea,LOC |
|
|
Term
| lab in tetraolgy of fallot: |
|
Definition
|
|
Term
| what is the imaging of choice for tetralogy of fallot? |
|
Definition
|
|
Term
| Tx for tetralogy of fallot: |
|
Definition
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