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Cyanotic Congenital Heart Anomalies
Pulmonary Atresia |
Pulmonary valve closed, ASD and PDA present, intact ventricular septum |
Transposition of the great vessels |
Complete transposition of the aorta and pulmonary artery |
Hypoplastic left heart syndrome |
Small left ventricle, normal great vessels |
Tetralogy of Fallot |
Subaortic septal defect, right ventricular outflow obstruction, overriding aorta, right ventricular hypertrophy |
Acyanotic Congenital Heart Abnormalities
ASD |
Opening between the left and right atria. Ostium secundum most common. |
VSD |
Opening between the left and right ventricle. **Most common of all congenital defects. |
AV Septal Defect (Canal) |
Due to incomplete fusion of the endocardial fusions. Common in Down Syndrome. |
PDA |
Failure/delay in closure of the channel bypassing the lungs (which during fetal development allows placental gas exchange) |
Coarctation of the Aorta |
Narrowing in the proximal thoracic aorta |
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Aortic/Mitral Valvular Disorders
Aortic Stenosis |
Narrowing of the valve opening |
Aortic Insufficiency (Regurg) |
Results in volume overload of left ventricle |
Mitral Stenosis |
Impedes blood flow between the left atrium and left ventricle |
Mitral Insufficiency |
Causes backflow and volume overload of left atrium |
Mitral Valve Prolapse |
Can range from asymptomatic to causing mitral regurg. |
Consequence of calve-related heart failure |
Pulmonary HTN + congestion |
Most common cause of mitral/aortic valve disorders |
Congenital defects* (also rheumatic heart disease, infix) |
Clinical scenario: female with minor chest wall deformity, mid systolic click, late systolic murmur |
Mitral valve prolapse |
Treatment |
surgical repair, valve replacement, and balloon valvuloplasty |
Recommendations |
Anticoagulation therapy esp. if pt. has Afib, and abc to prevent enocarditis if regurg. |
Tricuspid/Pulmonic Valve Disorders
Right-sided pressure overload leads to: |
Right-sided cardiomegaly, systemic venous congestion, and right-sided heart failure |
Clinical features |
Exercise intolerance, JVD, peripheral eema, hepatomegaly |
EKG Findings |
Right-axis deviation |
Echo Findings |
Definitive method for identifying structural/functional abnormalities |
Treatment |
Na+ restriciton, diruteic therapy --> decrease fluid volume and right atrial filling pressure |
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