Cardiology
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Pulmonary Atresia
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Pulmonary valve closed, ASD and PDA present, intact ventricular septum
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Transposition of the great vessels
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Complete transposition of the aorta and pulmonary artery
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Hypoplastic left heart syndrome
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Small left ventricle, normal great vessels
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Tetralogy of Fallot
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Subaortic septal defect, right ventricular outflow obstruction, overriding aorta, right ventricular hypertrophy
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ASD
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Opening between the left and right atria. Ostium secundum most common.
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VSD
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Opening between the left and right ventricle. **Most common of all congenital defects.
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AV Septal Defect (Canal)
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Due to incomplete fusion of the endocardial fusions. Common in Down Syndrome.
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PDA
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Failure/delay in closure of the channel bypassing the lungs (which during fetal development allows placental gas exchange)
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Coarctation of the Aorta
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Narrowing in the proximal thoracic aorta
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Aortic Stenosis
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Narrowing of the valve opening
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Aortic Insufficiency (Regurg)
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Results in volume overload of left ventricle
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Mitral Stenosis
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Impedes blood flow between the left atrium and left ventricle
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Mitral Insufficiency
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Causes backflow and volume overload of left atrium
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Mitral Valve Prolapse
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Can range from asymptomatic to causing mitral regurg.
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Consequence of calve-related heart failure
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Pulmonary HTN + congestion
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Most common cause of mitral/aortic valve disorders
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Congenital defects* (also rheumatic heart disease, infix)
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Clinical scenario: female with minor chest wall deformity, mid systolic click, late systolic murmur
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Mitral valve prolapse
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Treatment
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surgical repair, valve replacement, and balloon valvuloplasty
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Recommendations
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Anticoagulation therapy esp. if pt. has Afib, and abc to prevent enocarditis if regurg.
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Right-sided pressure overload leads to:
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Right-sided cardiomegaly, systemic venous congestion, and right-sided heart failure
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Clinical features
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Exercise intolerance, JVD, peripheral eema, hepatomegaly
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EKG Findings
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Right-axis deviation
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Echo Findings
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Definitive method for identifying structural/functional abnormalities
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Treatment
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Na+ restriciton, diruteic therapy --> decrease fluid volume and right atrial filling pressure
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