Advanced sono exam 3 (fetal echo)

optimal time to image fetal echo 

18-22 weeks

fetal echo can be performed as early as how many weeks?

10 weeks with TV and up to 16 weeks??

congenital malformations/ birth defects are caused by what

teratogens

most sensitive period for cardiac development in the 1st trimester?

3.5-6.5 weeks

which organ system is the first to reach a functional state?

cardiovascular

what weeks does circuclation begin?

3rd week

where does the vascular system begin?

in the wall of the yolk sac, connecting stalk and chorion

blank veins return blood from the embryo

cardinal

blank veins return blood from the yolk sac

vitelline

what is the caudal region of the primitive heart?

sinus venosus

what does the sinus venosus do?

receives all blood returning to the heart

the blank develops into the right ventricle

bulbus cordis

what dilates to form aortic sac from which the aortic arches arise?

truncus arteriosus

when does the division of the 4 heart chambers occur?

during the 4th and 5th week

the ductus arteriosus connects what?

between the aorta and the pulmonary artery

apical view of the heart

the primitive heart is a tubular structure that develops from blank cells

mesenchymal cells

paired endocardial heart tubes develop before the end of the blank week and begin to fuse, forming the primitive heart

third

what week does the heartbeat start

5th week

approx half of fetal blood passses through hepatic sinusoids; the rest bypasses the liver to go through the blank into the *blank

ductus venosus, IVC

after blood enters the SVC and IVC, where does it go?

right atrium

most of the blood from the IVC is directed by lower border of the blank through the foramen ovale into the left atrium

septum secumdum

small amount of oxygenated blood from the IVC is diverted by the blank and remains in RA to mix with deox blood from the DVC and coronary sinus

crista dividens

once blood moves into the LA where does it go?

it leaves the heart through the ascending aorta

three branches of the ascending aorta

innominate(brachiocephalic), left carotid and left subclavian

some of the blood in the RV goes through the blank

main pulmonary artery

pulmonary veins enter posterior of the blank

left atrium

cessation of placental circulation causes an immediate fall in BP in the newborns blanks

IVC and RA

Pressure in the LA becomes higher than in the RA after birth, causing blank to close

the foramen ovale

over time what causes complete closure of the foramen ovale?

adhesion of septum prmum to left margin of th eseptum secundum

what forms the floor of the fossa ovalis?

the septum primum

ductus arteriosus usually constricts blank hours after birth

24-48 hours

ductus arteriosus turns into the blank after birth

ligamentum arteriosum

normal fetal HR

120-160 bpm

in the 1st tri, HR begins arond blank

90 bpm, increasing to 170 before returning to normal

HR greater than blank is tachycardia

200 bpm

HR lower than blank is bradycardia

60 bpm

most common fetal risk factors for congenital heart disease

cardiac arrhythmias

what is associated with congenital heart disease?

presence of extracardiac abnormalities

other risk factors for CHD

IUGR, abnormal amniocentesis, amniotic fluid collections, HR and hydrops fetalis

maternal diseases affecting the fetus

diabetes, lupus and infection

if one parent has congenital heart defect, recurrance risk ranges from blank

2.5-4%

the apical 4 chamber view also contains what

the aorta

the parasternal view contains what

RV, LV, IVS, LA and Ao

the suprastenal view contains what

ascending Ao, right and left pulmonary artery, and SVC

cardiac window is found between what intercostal spaces

3rd and 5th

heart is displaced further toward the left chest

levoposition

heart is in the right chest with the apex pointed to the right thorax

dextrocardia

heart is in the right chest with apex pointed medially or to the left

dextroposition

heart is in atypical location with the apex pointing toward the midline

mesocardia

what is a disease of the myocardium, dialted chambers and thinning myocardial walls

cardiomyopathy

necrosis and destruction of myocardial cells and inflammatory infiltrate

myocarditis

failure of foramen ovale to close leads to what type of defect?

atrial septal- secundum type

what is the most common congenital lesion of the heart

ventricular septal defect

most common type of ventricular septal defect?

membranous (not muscular)

what is the failure of the endocardial cushion to fuse?

incomplete atriventricular septal defect

what is a single, undivided free floating leaflet stretching across both ventricles?

complete atrioventiruclar septal defect

what is an interruption of the growth of the tricuspid leaflet?

tricuspid atresia/stenosis

what is an abnormal displacement of the septal leaflet of the tricuspid valve?

Ebsteins anomaly of the tricuspid valve

symptoms of Ebsteins anomaly

SOB, fatigue, palpitations and cyanosis

what is an underdeveloped right side of heart due to obstruction of the RVOT and pulmonary artery stenosis?

hypoplastic right heart

what happens due to hypoplastic right heart?

reduced oxygen pickup which causes cyanosis

most common form of cyanotic heart disease in children/infants

tetralogy of Fallot

4 defects in tetralogy of fallot

pulmonary stenosis, VSD, dextroposition of the aorta and RV hypertrophy

wwhat is a small hypertrophied left ventricle with aortic or mitral dysplasia

hypoplastic left heart syndrome

symptoms of hypoplastic left heart syndrome

CHF, effusion and hydrops

hypoplastic left heart syndrome is autosomal recessive or dominant?

recessive

what condition is when the Ao is connected to the RV and the pumonary artery is connected to the left ventricle?

transposition of the great arteries

what is a discrete shelflike lesion that presents in the isthmus of the arch or near the left subclav artery?

coarctation of the aorta

what are multiple septal benign masses

rhabdomyomas

rhabdomyomas are associated with what

tuberous sclerosis

what is a heart lesion that forms from an abnormal development of the primitive heart outside the embryonic disk?

ectopic cordis