Acyanotic Congenital Heart Disease Flashcards

Vocabulary flashcards focusing on acyanotic congenital heart defects, including classifications, anatomical VSD variants, physical exam findings, and associated genetic syndromes.

L → R Shunts

Congenital heart disease lesions that cause volume overload, including VSD, ASD, PDA, and AVSD.

Obstructive Lesions

Congenital heart disease lesions that cause pressure overload, including PS, AS, and COA.

Echocardiography

Definitive non-invasive diagnostic modality for congenital heart disease, providing diagnosis in $95-98\%$ of cases.

Perimembranous VSD

The most common anatomical VSD type ($70-80\%$), located near the AV node, which can close spontaneously via tricuspid valve tissue.

Muscular VSD

Anatomical type of VSD ($5-20\%$) surrounded entirely by muscle, which can appear as multiple defects (Swiss cheese appearance) and has a high likelihood ($60\%$) of spontaneous closure.

Inlet VSD

Anatomical type of VSD ($5\%$) located posteriorly beneath the AV valves, strongly associated with Down Syndrome (Trisomy 21), which does not close spontaneously.

Outlet VSD

Anatomical subpulmonic VSD type ($5\%$) with higher incidence in Asian populations, carrying a high risk of Aortic Valve Prolapse and Regurgitation (AR), and which does not close spontaneously.

Small VSD Clinical Manifestations

Typically asymptomatic presentation with normal growth, normal ECG, normal CXR, and a classic loud, harsh holosystolic (pansystolic) murmur best heard at the LLSB, often with a thrill.

Moderate to Large VSD Clinical Manifestations

Presentation featuring failure to thrive (FTT), poor weight gain, CHF at $1-2$ months of age, holosystolic murmur at LLSB, mid-diastolic rumble at the apex, LVH/BVH/LAE on ECG, and cardiomegaly with increased pulmonary vascularity on CXR.

Secundum ASD

The most common pathology of Atrial Septal Defect, accounting for $75\%$ of ASD cases.

Sinus Venosus ASD

A type of atrial septal defect that is associated with Partial Anomalous Pulmonary Venous Return (PAPVR) in $90\%$ of cases.

Atrial Septal Defect (ASD) Physical Examination

Characterized by a widely split and fixed $S_2$, a systolic ejection murmur at the ULSB, and a mid-diastolic rumble from relative tricuspid stenosis at the LLSB.

Eisenmenger's Syndrome

A complication of untreated left-to-right shunts leading to pulmonary vascular obstructive disease, occurring at $1-2$ years of age in VSD and around $30$ years of age in ASD.

Moderate to Large PDA Physical Examination

Characterized by a continuous murmur at the LUSB, bounding peripheral pulses with a wide pulse pressure, and an optional apical diastolic rumble.

Endocardial Cushion Defect

Pathology comprising an Ostium Primum ASD, inlet VSD, and cleft mitral valve (most commonly Complete AV canal), strongly associated with Down Syndrome.

Pulmonary Stenosis

Obstructive lesion (valvular, subvalvular, or supravalvular) characterized by a systolic ejection murmur at ULSB radiating to the back, associated with Noonan's syndrome (PTPN11).

Aortic Stenosis

Obstructive lesion characterized by a systolic murmur loudest at URSB radiating to the carotid arteries bilaterally (or LLSB/ULSB in younger children), palpable thrill in the suprasternal notch in up to $85\%$ of patients, and associated with bicuspid aortic valve, coarctation of the aorta, and Williams' syndrome.