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what is the most common congenital cardiac lesions
Left to Right Shunts
what is the most common in children
Left to Right Shunts
what are the 3 types of Left to Right Shunts
Atrial Septal Defect (Patent Foramen Ovale )
Ventricular Septal Defect
Patent Ductus Arteriosus
what is Left to Right Shunts
hole in the heart that makes blood go from left to right. it causes mixing of the blood
what is another name patent foramen ovale
atrial septal defect
what age is atrial septal defect
utero
where is atrial septal defect
two atria in utero
what is atrial septal defect
when the baby is born and the foramen ovale does not close creating a shunt
describe what is happening in atrial septal defect
blood from the left side goes to the right ventricle and atrium causing hypertrophy and increased pulmonary vascularity. overloading occurs and pool in the right ventricle
how can we best demonstrate atrial septal defect
echocardiography
which gender is atrial septal defect found in more
females
how do we detect atrial septal defect usually
heart murmur
what is the difference in heart murmur between ventricular and atrial septal defect?
ventricular, it is audible
which one is more severe, ventricular or atrial septal defect
ventricular
when do we expect heart failure for ventricular septal defect
6-8 weeks
why is ventricular septal defect more serious?
because the pressure in the ventricles are greater in the ventricles
symptoms of ventricular septal defect
increased pulmonary blood flow, hypertrophy of the left atrium and ventricle
why is there no huge hypertrophy in the right ventricle in ventricular septal defect
most of the blood is sent to the pulmonary vasculature
Tx for ventricular septal defect
surgery
modality for ventricular septal defect
ultrasound
what kind of overloading do we see in ventricular septal defect, diastolic or systolic
diastolic
what is the RA for ventricular septal defect
hypertrophy of the left atrium and ventricle
not much enlargement of the right atrium/ventricle
increased vasculature
enlarged pulmonary trunk
what is patent ductus arteriosus?
when the vessel does not close in utero. this happens when the baby is born prematurely and does not close on the first breathe thus leaking blood in to the aorta
symptoms of patent ductus arteriosus
heart murmur
cyanosis
what age group is affected by patent ductus arteriosus
80% of preemies under 28 weeks
RA for patent ductus arteriosus
left side hypertrophy and pulmonary vasculature
where does the blood go in patent ductus arteriosus
aorta > lungs > pulmonary vascular congestion > blood returning to the left atrium
modality for patent ductus arteriosus
echocardiography
Tx for patent ductus arteriosus
fluid restriction, diuretics, surgery when they are a atleast a year old
what can complicate left to right shunts
pulmonary hypertension