Term
| What congenital disorder is due to an opening in the atrial septum permitting the shunting of blood between the atria? |
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Definition
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Term
| What are the 3 types of atrial septal defects (ASD)? |
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Definition
| Secundum, primum, and sinus venosus. |
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Term
| Is ASD more common in males or females? |
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Definition
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Term
| Most ASD _____ will close spontaneously? |
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Definition
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Term
| Is a patent foramen ovale (PFO) considered an ASD? |
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Definition
| No b/c no septal tissue is missing |
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Term
| Does intraatrial shunting occur w/ PFO? |
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Definition
| not as long as left atrial pressure exceeds right atrial pressure |
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Term
| Name 3 sx that occur in large ASDs. |
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Definition
| 1) FTT 2) Recurrent resp. infections 3) HF |
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Term
| Name 4 physicals signs seen in ASD. |
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Definition
| 1) Grade I-II/IV systolic ejection murmur 2)Splitting of S2 3)(R) ventricular impulse 4)Tachycardic |
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Term
| How do children w/ ASD appear physically? |
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Definition
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Term
| What is seen on CXR in ASD? |
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Definition
| may show cardiac enlargement, increased pulmonary vasculature |
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Term
| What is seen on EKG in ASD? |
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Definition
| RAD, prolonged PR interval |
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Term
| What is the test of choice for ASD? |
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Definition
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Term
| Name 2 tx approaches for ASD? |
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Definition
| Surgery or transcatheter approach |
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Term
| Describe the clinical presentation of ASD in an adult. (4) |
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Definition
| 1)Exertional dyspnea 2)Cardiac failure 3)loud systolic ejection murmur, split S2 4)Need to surgically correct if RV overload |
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Term
| PFO is a common cause of _________ in pts under 55 yo. |
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Definition
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Term
| Migraine HA may be more common in adults with _______. |
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Definition
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Term
| What is the most common congenital heart malformation? |
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Definition
| ventricular septal defect |
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Term
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Definition
| 1) Membranous (perimembranous) 2) Outlet 3) Inlet 4) Muscular |
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Term
| What is the most common site of VSDs? |
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Definition
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Term
| Because the bundle of his lies w/i the, VSDs may lead to _____. |
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Definition
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Term
| VSDs are subpulmonic, affecting blood flow out of _________ into _______. |
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Definition
| right ventricle, pulmonary artery |
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Term
| Do outlet VSDs affect usually close spontaneously? |
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Definition
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Term
| Inlet VSDs occur at the _______, affects blood flowing from ________ into the __________. |
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Definition
| atrioventricular canal, right atrium, right ventricle |
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Term
| Inlet VSDs are commonly associated with what other type of congenital heart malformation? |
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Definition
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Term
| Do VSDs typically close spontaneously? |
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Definition
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Term
| Where do muscular VSDs typically occur? Do they typically close spontaneously? |
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Definition
| right ventricular free wall. Yes. |
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Term
| What is a patent ductus ateriosis? |
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Definition
| vascular connection b/t the main pulmonary artery and the aorta |
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Term
| When does the ductus arteriosis usually close in term infants? |
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Definition
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Term
| What is the epidemiology of patent ductus arteriosis? |
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Definition
| 10% of congenital heart dz, F>M, > in premature at high altitudes (as high as 60% in infants born at 28wks) |
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Term
| Name 3 complications of patent ductus arteriosis. |
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Definition
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Term
| What is the first line tx for patent ductus arteriosis? What does it do? |
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Definition
| Indomethacin (NSAID). Reduces prostaglandin synthesis. |
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Term
| What are the side effects of Indomethacin? |
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Definition
| Renal dysfxn (high Cr), GI toxicity |
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Term
| What is an alternative tx for patent ductus arteriosis? |
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Definition
| Ibuprofen - less side effects |
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Term
| What surgical tx is available for patent ductus arteriosis? |
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Definition
| Percutaneous occlusion (coil occlusiosn, Amplatzer duct occluder, Rashkind umbrella device) |
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Term
| Spontaneous closure of patent ductus arteriosis may occur up to age ___. What can happen if it doesn't close? |
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Definition
| 1yr. CHF, poor growth, frequent pulm. infxns. |
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Term
| What is narrowing of the thoracic aorta distal to left subclavian artery? |
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Definition
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Term
| Which gender is aortic coarctation more common in? |
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Definition
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Term
| Coarctation of the aorta, alone or in combination w/ VSD/ASD, is the most common cause of ________ in the newborn. |
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Definition
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Term
| Name 3 congenital resons for coarctation of the aorta. |
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Definition
| 1) Functional defect in aortic wall 2) Increased collagen 3) Decreased smooth muscle |
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Term
| What are aquired reasons for coarctation of the aorta? |
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Definition
| inflammatory dz or severe atherosclerosis |
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Term
| How does coarctation of the aorta affect pulses? |
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Definition
| decreased or absent femoral pulses |
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Term
| What other clinical manifestations occur in coarctation of the aorta? |
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Definition
| Systolic HTN in UE, 2/6 systolic murmur, sx worsen as PDA closes |
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Term
| How is dx confirmed in coarctation of the aorta? |
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Definition
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Term
| What is a complication of coarctation of the aorta that occurs b/t the ages of 10-30? What is the tx of choice? |
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Definition
| Intracranial aneurysms, clipping the base is tx of choice |
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Term
| What is a rare complication of coarctation of the aorta? |
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Definition
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Term
| Why is important to tx coarctation of the aorta? |
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Definition
| to prevent HTN later in life |
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Term
| What is the tx of choice for <6mths of age? 6mths to 5yrs? |
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Definition
| Surgery. Surgery or angioplasty. |
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Term
| What is the tx for coarctation of the aorta for >5yo? What are possible complications of the tx? |
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Definition
| Balloon angioplasty w/ stent placement. Aneurysm or aortic dissection. |
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Term
| What is the f/u management of coarctation of the aorta? |
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Definition
| MRI one yr /p procedure and then q 3-5yrs to monitor for recoarctation or aneurysm formation. |
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Term
| Describe the clinical presentation of an adult w/ coarctation of the aorta. (4) |
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Definition
| 1) HTN 2) HTN in arms, normal in legs (worse w/ exercise) 3) Weak femoral pulses 4) Strong carotid pulsation |
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Term
| What is the prognosis of untreated coarctation of the aorta in adults? |
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Definition
| Most die b/f 50yo from HTN, aortic rupture, IE, cerebral hemorrhage, or aortic dissection. |
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Term
| Name the 4 anatomic abnormalities seen in the congenital heart condition Tetralogy of Fallot. |
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Definition
| 1) Stenosis of Pulm. art. 2) VSD 3) Dev. of aorta origin to (R) 4) Concentric RVH |
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Term
| Is Tetralogy of Fallot more commmon in men or women? |
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Definition
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Term
| What is the hallmark sign of severe Tetralogy of Fallot? |
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Definition
| Tet spells - sudden onset of cyanosis, dyspnea, and alteration in consciousness. |
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Term
| Name 2 other clinical presentations of Tetralogy of Fallot. |
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Definition
| Cyanosis and harsh systolic ejection murmur in upper LSB |
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Term
| What lab finding is expected in Tetralogy of Fallot? Why? |
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Definition
| HGB/HCT, RBC inc. d/t art. desaturation |
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Term
| What is the diagnostic test of choice for Tetralogy of Fallot? |
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Definition
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Term
| What are palliative tx for Tetralogy of Fallot? |
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Definition
| Oral B blockers and balloon angioplasty |
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Term
| What is the ultimate tx for Tetralogy of Fallot? |
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Definition
| Surgery (birth to 2yo, usu. 6mth if asymptomatic) |
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Term
| What congenital heart defect, if it is large, causes a 4/6 continuous machinelike murmur that does not change w/ position? |
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Definition
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Term
| Name 3 signs of HF in a large patent ductus arteriosus? |
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Definition
| 1) FTT 2) Poor fdg 3) Resp. distress |
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Term
| What is the gold standard test for dx of patent ductus arteriosis? |
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Definition
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