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Associate the good consequence to the good type of cardiac shunt:
A) R → L shunts
B) L → R shunts
2) congestive heart failure
- R → L shunts give cyanosis
- L → R shunts give congestive heart failure
Name 5 consequences of cyanosis
- brain abcesses
- hypertrophic osteoarthropathy
What is Eisenmenger's syndrome?
A shift from L→R shunt to R →L shunt
Is Eisenmnger's syndrome reversible?
What means Eisenmenger's syndrome at the pulmonary level?
it is a sign of increasing pulmonary vascular resistance and pulmonary HTN
What is the first sign of congestive heart failure in children?
3 causes of L→R shunts
- VSD (ventricular septal defect)
- ASD (atrial septal defect)
- PDA (patent ductus arteriosus)
3 causes of R→L shunts
- tetralogy of Fallot
- transposition of the great vessel
- truncus arteriosus
To wich structures the ductus arteriosus is connected?
- descending aorta
- left pulmonary artery
What is the purpose of the ductus venosus in utero?
blood shunt away from liver
To wich structures the ductus venosus is connected?
- inferior vena cava
- portal vein
In wich direction is the blood travelling in the 2 umbilicals arteries?
from fetal circulation to placenta
In wich direction is the blood travelling in the umbilical vein?
From placenta to fetal circulation
What is the most commun congenital heart defect?
VSD (venticular septal defect)
When does VSD symptoms usually begins?
4-6 weeks of life (as pulmonary vascular resistance decrease and shunt increase)
What are the clinical elements (4) found in large ventricular septal defects
- congestive heart failure
- failure to thrive
What are the 2 elements of medical tx of ventricular septal defects?
What are the indications to repair a ventricular septal defect?
- - CHF resulting in failure to thrive (most commun reason)
- - before school age if doesn't close spontaneously
- - pulmonary vascular resistance more than 4-6 Woods unit
- - Attention! if more than 10 Woods units contreindication, try vasodilatator first and if reversible can repair
What is the direction of the shunt in:
c) Tetralogy of Fallot
d) Transposition of the great vessels
e) Truncus arteriosus
f) Patent ductus arteriosus
- a) L→R
- c) R→L
- d) R→L
- e) R→L
- f) L→R
What are the 2 kinds of atrial septal defects?
- ostium primum (also called atrioventricular septal defect or endocardial cushion defect, more inferior defect)
- ostium secondum (central defect, most commun)
Name 3 anomalies in venous return that can be found in ostium secundum ASD
- 1) pulmonary venous return in IVC
- 2) pulmonary venous return in right atrium
- 3) IVC connect to the left atrium
Name the 2 elements of the medical tx of ASD
What are the indications to repair a atrial septal defect?
- -volume overload (Qp/Qs more than 1.5)
- -before shool age if doesn't close spontaneously
- -pulmonary venous resistance more than 10-12 Woods unit is a contraindication
- - all ostium primum defects