Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
26 Cards in this Set
- Front
- Back
When does cardiac embryogenesis begin |
3rd week of gestation |
|
When does fetal heart circulation begin |
8th week of gestation |
|
In fetal circulation, where does oxygenation of blood take place |
Placenta |
|
Closure of ductus arteriosus |
Functional closure is usually complete within 10-15 hours of birth Anatomical closure occurs within 3 days of life |
|
Closure of foramen ovale |
Functional closure by 3 months of life |
|
Incidence of congenital heart disease |
8-10 per 1000 live births in developed countries |
|
Etiology |
Multifactorial 1. Genetic factor: down syndrome 2. Drugs: folic acid antagonists, alcohol, warfarin 3. Viruses: rubella 4. Diabetic mothers 5. Environmental factors: esp exposure to radiation |
|
Classification of CHD |
1. Cyanotic CHD 2. Acyanotic CHD |
|
Acyanotic CHD |
A. Shunt defects •ventricular septal defect •patent ductus arteriosus •atrial septal defect •atrioventricular canal defect B. Obstructive defects •isolated pulmonary stenosis •isolated aortic stenosis •coarctation of the aorta |
|
Cyanotic CHD |
•Tetralogy of Fallot •Transposition of the great arteries •Isolated tricuspid atresia •single ventricle with pulmonary stenosis •truncus arteriosus •double outlet right ventricle •isolated pulmonary artresia |
|
Commonest cyanotic cardiac defect beyond neonatal period |
TOF |
|
Features of TOF |
1. Pulmonary stenosis 2. Ventricular septal defect 3. Overriding aorta 4. Right ventricular hypertrophy |
|
Clinical manifestations of TOF |
•central cyanosis •delayed tooth eruption •digital clubbing by 1-2 years •dyspnoea on exertion •squating, sitting or lying down after playing for a while •paroxysmal dyspnoeic attack (hypercyanotic spell): if severe - hemiparesis, coma, seizures, metabolic acidosis • |
|
Diagnosis of TOF |
•chest x-ray: boot shaped heart with hollow pulmonary bay •echocardiography •ECG •cardiac catheterization •angiogram |
|
Management of TOF |
1. Keep the patient in knee chest position 2. Give oxygen 3. Administer bicarbonate in case of metabolic acidosis 4. Morphine injection 5. Propranolol injection 6. Surgery is the mainstay: a) palliative surgery: shunt creation (aortopulmonary shunt) b) total repair surgery |
|
Complications of TOF |
1. Cerebral thrombosis due to polycythemia secondary to hypoxia 2. Bacterial endocarditis 3. Bleeding tendencies 4. Congestive cardiac failure |
|
Most common congenital cardiac defect |
Isolated VSD |
|
Incidence of VSD |
Accounts for 20-40% of all cardiac defects and occurs equally in both male and female. 80% of VSD is located at the membranous septum |
|
Type of murmur in VSD |
Pansystolic murmur |
|
Complications of VSD |
Heart failure Infective endocarditis |
|
Management of VSD |
•assurance of the mother because of history of closure of defect and reduced size by 5 years •give penicillin prophylaxis for infective endocarditis •give antibiotics before any dental procedure •surgical closure is done for large defects |
|
Aetiological factors in patent ductus arteriosus |
Prematurity Maternal rubella Perinatal asphyxia |
|
Commonest congenital cardiac defect in preterm in the neonatal period |
Patent ductus arteriosus |
|
Pulse in PDA |
Bounding and collapsing |
|
Type of murmur heard in PDA |
Continuous machinery murmur |
|
Management of PDA |
Can be treated medically with indomethacin Surgical treatment will be needed in all PDA |