Cardio E1 : Congenital

What CHD are acyanotic?

CAPVAP: Coarc of Aorta, AS (bicusp), PDA, VSD, ASD, PS

What CHD are cyanotic?

TETE: Tetralogy of Fallot, Eisenmenger’s, TGA, Ebstein anomaly

What is the most common cause of AS?

bicuspid aortic valve

When are ppl most often dx w/ AS?

5th and 6th decade

Midsystolic high-pitched crescendo-decrescendo murmur w/ opening click

PS

What is the tx for PS?

percutaneous balloon valvuloplasty

What is the most common ASD?

PFO

What do PFOs cause?

cryptogenic strokes in young adults

midsystolic murmur, fixed split S2

ASD

What is the tx for ASD?

surgical closure; PFOs may be closed percutaneously

Why do we rarely see VSD in adults?

most close during childhood

holosystolic, w/ thrill at LLSB

VSD

What demo are PDAs most common in?

premature infants

loud, continuous machine murmur

PDA

How can we tx small PDAs?

NSAIDS (IV Indocin)

How do we tx large PDAs?

surgical closure

What is the MC extracardiac abnormality associated w/ coartation of the aorta?

aneurysm in the circle of Willis

What do we need to screen pts w/ Coartation of the Aorta for?

Berry aneurysms

When are most Coartation of the aorta dx?

in adulthood due to workup for secondary HTN

What kind of pulses will be present w/ coartation of the aorta?

forceful carotid and UE pulses; weak and delayed LE pulses

systolic murmur heard over L upper back

Coartation of the aorta

What does the CXR show in coartation of the aorta?

Rib notching or Figure 3 sign

What is the tx for coartation of the aorta?

surgical repair

What is a R → L shunt flow w/ variable degrees of cyanosis (more prominent in LE)?

Eisenmenger’s syndrome

What is the prognosis for Eisenmenger’s?

poor; high mortality

What is an “atrialized” Right ventricle?

Ebstein’s anomaly

What is the best dx test for Ebstein’s?

TTE

What would you see on a CXR for Ebstein’s?

giant RA & RV w/ small PA & normal LV

What is Tetralogy of Fallot?

4 defects in one

What are the defects seen in Tetralogy of Fallot?

PROV: PS, RVH, Overriding aorta, VSD

What is Transposition of the Great Vessels?

Aorta & pulmonary artery are switched

What is the tx for TGA?

surgery to correct the position of the vessels