Congential core ii
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5 causes of congenital heart defects
- 1. single gene defects
- 2. environmental factors
- 3. maternal ingestion of toxic substances
- 4. viral exposures
- 5. unknown
Three types of cells that make up the fetus and what parts for each one
- 1. Ectoderm -skin, hair, teeth, nervous system
- 2. Endoderm -gut and all the glands
- 3. Mesoderm - the heart
Important days in development of fetal heart.
- single tube- 23 days
- complete heart- 43 days
5 areas of heart tube and which each one develops into
- 1. truncus arteriosus - AO and MPA
- 2. conus cordis - outflow tracts
- 3. the common ventricle - inlet of ventricles
- 4. the common atrium - RT and LT atrium
- 5. the sinus venosus - Prox Vena Cava and part of right atrium
Two types of looping in development?
Normal or Abnormal?
- 1. Dextro or d-looping - right - normal
- 2. Levo or l-looping - left - abnormal
What chambers are the first to separate?
What is important to remember about this separation?
the never completely separate during fetal development
Three types of ASDS?
- Ostium primum- near valves
- Ostium secundum- middle - most common
- Sinus Venosus- farthest from valves
What is the most common congenital defect in infants?
What is the most common congenital defect in adults?
Two types of VSDS?
1. Perimembranous LV to RA
2. Muscular LV to RV - more common
What defect is associated with Down's Syndrome?
Percent of patients?
What is wrong?
Affects what valves
- Endocardial Cushion Defect
- 40% of Down Syndrome children
- Partial or complete AV canal defect
- Affects: MV and TV
- heart failure
What defect is the partial or complete absence of a valve, particularly the TV?
With Ebstein's anomaly what will happen to which valve?
What might also be present? (3)
What development causes a narrowed right ventricular outflow tract?
unequal division of the conus cordis
What four things must be present to be considered Tetralogy of FAllot?
- 1. RVOT/infundibular stenosis (velocity > 2 m/s)
- 2. VSD
- 3. RVH
- 4. Overriding aorta
One sign and symptom of Tetralogy of Fallot
Children will turn bluish when crying or feeding.
How many congenital cases are Tetralogy of Fallot?
What are the two types of Transposition of the great arteries?
- 1.) D-transposition
- Simple transposition
- Transposition of the Great Arteries
- 2.) L-transposition
- Corrected transposition
What is the characteristic of D-transposition?
- Only one wrong connection.
- Atria correct ventricle but wrong great artery attached to the ventricle.
What is the characteristic of L-transposition?
What happens in the heart?
What is common with this type of transposition?
Wrong atria to the wrong ventricle and wrong great vessels to the wrong great vessel.
The RV cant pump blood to the rest of body longterm. Not thick enough myocardium so the RV will give out.
VSD with pulmonary HTN
What is the ductus arteriosus called after birth?
How many cases of congenital are coarctation?
What may also be present with coarctation?
- 1.) bicuspid AV
- 2.) VSDs
- 3.) PDA
What happens to the heart with PDA? (8)
- 1.) huge volume overload on the left side of heart
- 2. RA - unchanged
- 3. RV - abnormal thickening
- 4. LA - unchanged or increased pressure
- 5. LV - unchanged or increased pressure
- 6. Ascend AO - unchanged pressure
- 7. Descend AO - increased pressure
- 8. MPA - increased pressure
- 9. Pulm vessels - unchanged
What happens to the heart with Pulmonary Stenosis? (3)
What to do to scan?
- 1. RV enlargement
- 2. MPA enlargement
- 3. Left side will be normal
1. PW in RVOT, MPA, LPA & RPA to check for obstruction will have velocities > 2 m/s.
What pathology does the doctors want to be present with Hypoplastic Left-Heart Syndrome?
PDA to allow the blood flow and help maintain pressure but blood will not be oxygenated.
How does the fetus get oxygen?
What takes oxygen out of the blood?
Distribution of Oxygenated Blood from the Aorta (4)
- 1.) 62% - carotid and upper body
- 2.) 29% - descending AO to rest of the body
- 3.) 12% - lungs
- 4.) 9% - coronary arteries to the heart
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