In fetal development, how are the common atrium and ventricles formed?
The tube rotates upon itself and forms the atrium and ventricles.
In fetal development, what separates into the pulmonary arteries and aorta?
the common truncus arteriosus
What term describes the formation of the atrioventricular canal separating the atria from ventricles?
Endocardial cushions. They are two thicker areas that develop into the walls (septum) that divide the four chambers of the heart.
T/F. The aorta and pulmonary veins have a common trunk called the Truncus Arteriosis
False. It is the aorta and pulmonary arteries that have Truncus Arteriosis
In fetal circulation, 75% of blood from ductus venosus and IVC are directed through the ____ ____ into the left atria.
Foramen ovale
Why do fetuses have a ductus arteriosis?
because the lungs are not used while a fetus is in the womb, baby gets oxygen directly from the mother’s placenta.
The incomplete formation of the atrial septum is called _____.
Atrial septal defect
The incomplete formation of the ventricular septum is called _______.
Ventricular septal defect
Tetralogy of Fallot is caused by the malalignment of the conal septum separating the ______ from the ______ outflow tracts.
pulmonary from the aortic
T/F Persistent Truncus Arteriosis is the failure of septation between the pulmonary veins and pulmonary arteries.
False. It’s between the aorta and pulmonary arteries.
What is the most common type of CHD in children?
ventricular septal defect (VSD)
T/F the most common type of CHD in adults is ventricular septal defect.
False. It’s atrial septal defect (ASD)
The congenital cardiac lesion in which there is complete mixing of deoxygenated and oxygenated blood is called what?
Admixture lesion. MC example is truncus arteriosis
T/F- ASD has to be surgically corrected.
False, it has a high spontaneous closure rate
T/F- Patients with ASD are usually asymptomatic
True. However, adults may be easily fatigued and also have exertional dyspnea
ASD causes ____ to ____ shunt
left to right d/t higher pressure in left atria
What diagnostic lab/imaging should you order to differentiate between VSD and ASD?
Echo, then order 2-D color doppler for eval.
The most common isolated congenital cardiac malformation is ______. And it accounts for __ % of all congenital cardiac anomalies
VSD. 20%
Why are LA, LV, and pulmonary a. enlarged in VSD?
Volume overload. Same reason why there is RV and right artery HTN
What is Eisenmenger syndrome and why is it rare?
When a long standing L -> R shunt causes pulmonary HTN, resulting in flip of shunt, oxygen-poor blood to flow from the R -> L ventricle and then to the body, causing cyanosis. The high pressure also causes the wall of your heart’s right ventricle to hypertrophy.
When the atrial septum, ventricular septum, and mitral/tricuspid valves have a defect resulting in incomplete closure is called ______.
Endocardial cushion defect or AV cushions.
What CHD sounds like a machine murmur?
Patent ductus arteriosis, blood is flowing from aorta to pulmonary a. during systole and diastole
In what patients is patent ductus arteriosis most seen?
Premature babies, infant exposed to hypoxemia, birth at high alt, and rubella exposure early on in infancy.
Obstruction of the ductal region of aorta is called ______. What are some physical findings?
Coarctation of aorta. UE HTN, absent LE pulses, systolic murmur heard in left sternal border
In coarc, blood gets beyond by anastomoses of what arteries?
costcocervical trunk, intercostal, lateral thoracic, internal thoracic.
Why does rib notching occur in coarc?
D/t dilated tortuous intercostal arteries putting pressure on adjacent ribs.
If you see a blue baby, they likely have ______ and that’s due to ______ shunt.
Tetralogy of fallot d/t R -> L shunt, deoxygenated blood mixing with oxygenated.
What is a major defect of tetralogy of fallot?
Pulmonic stenosis and right ventricular outflow obstruction.
All of the following may be an atrial septal defect (ASD) except for:
a. Ostium primum
b. Ostium secundum
c. Sinus venosus
d. Sinus arteriosis
d. Sinus arteriosis
In ASD, a fossa ovalis defect is called
a. Ostium primum
b. Ostium secundum
c. Sinus venosus
d. Sinus arteriosis
b. Ostium secundum. Defect in mid septum
The most common congenital cardiac malformation in 6 month old baby is-
a. ASD
b. VSD
c. Tetralogy of fallot
d. AV cushion defect
b. VSD
Endocardial (aka AV) Cushion has a high incidence in patients who are-
a. premature
b. young teens
c. down syndrome
d. exposed to viral infections early on
c. down syndrome (per Dr. W if you also hear murmur with these pts be concerned)
Majority of Patent Ductus Arteriosis close within
a. 4-7 days
b. 7-10 days
c. 14-22 days
d. Never close
a. 4-7 days
If not by 4-7 days, virtually all Patent Ductus Arteriosis close by-
a. by 6 months
b. by 12 months
c. by 24 months
d. by 48 months
b. 12 months (year one)
CXR findings in Patent Ductus Arteriosis MAY include:
a. mild cardiomegaly
b. rob notching
c. “E” sign
d. “3” sign
a. mild cardiomegaly
CXR findings in tetralogy of fallot MAY SHOW-
a. nothing abnormal
b. ceur en sabot
c. boot shaped
d. two of the above
e. all of the above
e. all of the above