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CHD
| Question | Answer |
|---|---|
| CHD vs. AHD | CHD is present at birth AHD is acquired after birth |
| Environmental risk factors of CHD(5) | Rubella exposure, maternal alcoholism, diabetes mellitus, advanced maternal age, maternal drug ingestion(street or medication) |
| Genetic risk factors of CHD(3) | Presence of sibling or parent with CHD, chromosomal anomalies and presence of other non cardiac congenital anomalies |
| Classifications of physiologic characteristics of CHD(4) | Increased pulmonary blood flow, Decreased pulmonary blood flow, obstruction of pulmonary blood flow and mixed blood flow |
| Most common defects involving increased pulmonary blood flow | Patent Ductus Arteriosus(PDA), Atrial Septal Defect(ASD) and Ventricular Septal Defect(VSD) |
| Atrial Septal Defect | An abnormal opening in the atrial septum that enables oxygenated blood to flow from the higher pressure left atrium to the lower pressure right atrium causing blood to become deoxygenated |
| Cardinal manifestation of CHD | Signs of Congestive Heart Failure |
| Manifestations of Atrial Septal Defect | frequent respiratory infections, dyspnea, harsh systolic murmur heard on auscultation over 3rd intercostal space |
| Medical Management for Atrial Septal Defect | Minor cases are only monitored. Cardiopulmonary bypass may be performed in severe cased |
| Ventricular Septal Defect | An abnormal opening in the interventricular septum resulting in flow of oxygenated blood from high pressure left ventricle to lower pressure right ventricle causing blood to become deoxygenated |
| Manifestations of Ventricular Septal Defect | Initially may be asymptomatic but cardinal signs include loud harsh systolic murmur and a palpable thrill |
| Medical Management of Ventricular Septal Defect | About 50% of VSD cases resolve spontaneously. Pulmonary artery banding is necessary in symptomatic cases in order to impede blood flow through the septal defect |
| Most common defects involving decreased pulmonary blood flow | Pulmonary stenosis, Pulmonary Atresia and tetralogy of Fallot |
| Combination of defects involved in tetralogy of Fallot | 1)pulmonary stenosis 2)VSD 3) Right Ventricular Hypertrophy 4)Overriding Aorta |
| Manifestations of Tetralogy of Fallot | Acute episodes of severe cyanosis and hypoxia, systolic ejection murmur, clubbing of nail beds, dyspnea, squatting, poor growth, mental slowness, syncope and stroke |
| Medical management of tetralogy of fallot | Blalock-Taussig shunt for palliative treatment of cyanosis and hypoxia by way of creating an artificial opening between the pulmonary artery and the aorta. Complete correction involves VSD closure, pulmonic valvotomy and repair of overriding aorta |
| Most common defects involving mixed defects | Transposition of great vessels, truncus arteriosus and hypoplastic left heart syndrome |
| Transposition of great vessels | The pulmonary artery arises from the left ventricle and the aorta arises from the right ventricle. This causes blood returning to the right side of the heart to exit through the aorta without being oxygenated and oxygenated blood to be returned to the lun |
| associated defects must be present to allow for communication between two circulations in order for the fetus to survive in this: | Transposition of the Great Vessels |
| Clinical Manifestations of Transposition of the Great Vessels | If minimal communication between circulations then profound cyanosis will be present. Cardiomegaly will be present in most cases |
| Medical Management of Transposition of the Great Vessels | Palliative treatments include enlarging/creation of atrial septal defect . Complete correction involves switching great vessels to their proper places |
| Most common defects involving obstruction to systemic blood flow | Aortic stenosis, pulmonary stenosis and coarctation of the aorta |
| coarctation of the aorta | A narrowing of the lumen of the aorta resulting in increased pressure proximal to the defect and decreased pressure distal to the defect |
| Clinical manifestations of coarctation of the aorta | Blood pressure that is 20mmHg higher in the arm than in the legs(reversal of normal pattern), bounding pulse in lower extremities, leg cramping on exertion and epistaxis |
| medical management of coarctation of the aorta | excision of the narrowed portion of the aorta with anastomosis(connecting between the two great vessels) or graft replacement in cases of extensive narrowing |
| Causes of Acquired Heart Disease(4) | Autoimmune processes, infection, familial tendencies and environmental factors. |
Created by:
Meek91
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