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
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 |
|
|
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 |
|
|
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 |
|
|
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 |
|
|
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 |
|
|
Term
|
Definition
1. ECG - LVH 2. CXR -notching of ribs -Figure 3 appearance |
|
|
Term
Complications of Coarctation of A |
|
Definition
-Severe HTN -Rupture of cerebral aneurysm -Infective endocarditis -Aortic dissection |
|
|
Term
|
Definition
-Sx decompression -Percutaneous ballon aortoplasty in some cases |
|
|
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 |
|
|
Term
What keeps PDA in fetal life |
|
Definition
prostaglandins and low oxygen tension keep open -blood is shunted away from nonfunctioning lungs |
|
|
Term
|
Definition
Rubella syndrome High altitude Premature birth |
|
|
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 |
|
|
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 |
|
|