| Question |
Answer |
| What is the septum primum? |
The septum that grown from top of primitive atrium down to the endocardiac cushion to divide primitive atrium into L and R atrium |
| What is the ostium primum? |
Small opening at bottom of septum primum, which closes when osteum secondum forms |
| What is the septum secondum? |
The second layer that forms, dividing the two atria. |
| What is the foramen ovale? |
The orifice through which blood flows from the RA to LA. Located in the septum secondum |
| What is the osteum secondum? |
a perforation in the septum PRIMUM |
| Where is the osteum secondum located? |
In the septum primum (top) |
| What causes the foramen ovale to close? |
The foramen ovale is closed by the septum primum due to higher pressure in the LA than the RA |
| What closes the foramen ovale? |
Septum primum due to higher pressure in the LA than in the RA. Septum primum is in the LA, and pushes in toward the RA to close the foramen ovale |
| Atrial Ventricular Septal Defect is often comorbid with what genetic disorder? |
Trisomy 21 |
| Coarctation of the aorta is most commonly associated with what genetic disorder? |
Turners. 45, XO |
| What kind of shunt is cyanotic ? Acyonotic? |
Cyanotic: R to L shunt. Acyanotic L to R shunt. L to R shunt can progress to an R to L shunt in time making it cyanotic. |
| Give two examples of acyanotic congenital heart defects. |
L to R shunt (AVSD, VSD, ASD, PDA) and defects causing a blood flow obstruction (coarctation of the aorta, valvular stenosis of the aorta or pulmonic valves) |
| Coarctation of the aorta: Cyanotic or acyanotic? |
Acyanotic |
| Give 4 examples of cyanotic congenital heart diseases |
Defects causing a right to left shunt: **THE T's** *T*etrology of fallot, *t*ransposition of the great arteries, persistent *t*runcus arteriosis, and *t*ricuspid atresia |
| What is eisenmenger syndrome? |
Reveral of L to R shunt (becomes a R to L shunt --> cyonotic CHD) due to right pressure exceeding left pressure |
| Major complications of a L to R shunt? |
Pulm htn with RV hypertrophy, which progresses to a R to L shunt (eisenmenger syndrome) due to pulm a. pressure exceeding aortic pressure. |
| What is a paradoxical emboli? What kind of shunt is it involved in? |
A paradoxical emboli is an emboli that originates in a vein and then travels to the right side of the heart where it then crosses to the left side in the presence of a hole b/w the 2 chambers. It then travels to the brain causing a stroke |
| What is the biggest complication of a R to L shunt |
brain infarction / abscess due to paradoxical emboli |
| What is the most common kind of atrial septal defect (ASD) |
ostium secundum defect (OS is too large either due to absence of septum secundum or excess resorption of septum primum) |
| What are the two mechanisms for ostium secundum defect? |
OS is too large due to: 1) absent septum secundum or 2) excess resorption of septum primum |
| What is the an associated disease that cause a patent ductus arteriosis |
Congenital rubella infxon. Causes L-> R shunt |
| Coarctation of the aorta is associated with what heart defect? |
bicuspid aortic valve |
| What is coarctation of the aorta? |
A ridge like infolding of the aorta just opposite to the DA, located either preductally (infantile) or postductally (adult) |
| What are some clinical manifestations of coarctation of the aorta? |
LV hypertrophy, dilation of collateral arteries (intercoastal aa and internal mammary a.) made apparent by presents of ib notching on cxr. Delayed/weak femoral pulse, elevated BP in upper body (nosebleeds, berry aneurysms, etc), midsys ejection murmur, |
| What congenital heart disease as associated epistaxis, ha, and elevated BP in upper body, and leg atrophy? |
Coarctation of the aorta. Leg atrophy is due to reduced BP in legs. |
| Notching of the ribs is a sign of what congenital heart disease. |
coarctation of the aorta. This is due to dilation of arteries leading to PRESSURE ATROPHY of the ribs |
| components of tetrology of fallot |
ventricular septal defect, hypertrophy of the right ventricle, overriding aorta, pulmonary stenosis. |
| What are the clinical manifestations of tetralogy of fallot? |
Cyanosis ( R to L shunt) **TET SPELLS - cyanosis after crying or feeding**, squatting, pulmonic stenosis with RV hypertrophy. *Boot shaped heart on CXR* |
| What is transposition of the great arteries? |
Aorta arises from the RV, pulmonary a. arises from LV. MEDICAL EMERGENCT. due to conotruncal septum failing to follow its normal spiral course... it only runs up and down |
| How is transposition of the great arteries (TGA) managed? |
Prostaglandin infusion to maintain DA, followed by balloon catheter to create interatrial foramen, and then surgical switch of the vessels |
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