-
Shunts causing cyanosis
Right to left
-
Compensatory measure children use to increase SVRI and decrease R to L shunt
Squatting
-
Complications of cyanosis (5)
Polycythemia, stroke, brain abscess, endocarditis, hypertrophic osteoarthropathy
-
Shift in shunt from left to right, to right to left as pulmonary vascular resistance increases
Eisenmenger�s syndrome
-
Shunts causing failure to thrive
Left to right
-
First sign of CHF in children
Hepatomegaly
-
VSD, ASD, PDA
Left to right shunts
-
Tetralogy of fallot, TGA, truncus arteriosus
Right to left shunts
-
Connection between descending aorta and left pulmonary artery
Ductus arteriosus
-
Connection between portal vein and IVC
Ductus venosum
-
Number of placental arteries and veins (normal)
2 arteries, one vein
-
most common congenital heart defect
VSD
-
Medical treatment of VSD
Diuretics, digoxin
-
Timing of VSD repair if not spontaneously closed
Before school age
-
Most common ASD; centrally located patent foramen ovale
Ostium secundum
-
Atrioventricular septal defects, or endocardial cushion defects
Ostium primum
-
Timing of ASD repair if not spontaneously closed
Before school age
-
Woods units that contraindicate repair of ASD or VSD
>10-12
-
Tetralogy of Fallot
VSD, pulmonic stenosis, overriding aorta, RV hypertrophy
-
Most common congenital heart defect resulting in cyanosis
Tetralogy of Fallot
-
Medical treatment of Tetralogy
Beta blocker
-
Palliative procedure to delay definitive tetralogy repair
Blalock-Toussig shunt
-
Most common cyanotic congenital heart defect diagnosed in the 1st week of life
Transposition of the great vessels
-
Medical treatment of transposition
Atrial septostomy, PGE1 for ductus
-
Surgical repair of transposition
Early switch with coronary reimplant (unless LVOT is present)
-
Congenital heart defect with associated VSD and 80% one-year mortality
Truncus arteriosus
-
Medical treatment of truncus arteriosus
Diuretics, digoxin, fluid restriction, afterload reduction
-
Drug that causes PDA to close
Indomethacin
-
Drug that keeps PDA open
Prostaglandin
-
Location of coarctation of aorta
Just distal to left subclavian
-
Chest x-ray finding in coarctation
Notching of ribs from IMA/intercostal collaterals
-
Procedure used in univentrical hearts
Fontan
-
Prerequisates for fontan (PA pressure and PVR)
Normal PA pressure (<20mmHg) and normal PVR (<2 Woods units)
-
Procedure for hypoplastic left heart
Norwood
-
Fontan procedure (describe)
Attach RA and SVC to PA
-
Norwood procedure (describe)
Aorta augmented with allograft artery and attached to PA. Distal PA�s supplied through BT shunt
-
Associated defect with TAPVR (total anomalous pulmonary venous return)
ASD
-
Treatment of double aortic arch
Ligate smaller arch
-
Most common cause of death in US
Heart disease
-
Pattern where Posterior descending artery comes off of right coronary
Right dominant circulation
-
Pattern where posterior descending artery comes off of circumflex coronary
Left dominant circulation
-
Most common pattern of coronary circulaion
Right dominant
-
S/p MI, now with pansystolic murmur: dx?
Papillary muscle rupture, free wall rupture
-
Most common time for free wall rupture after MI
3-7 days
-
post MI complication seen most ofter after large, transmural, anterior MI
LV aneurysm
-
Restenosis rate of PCTA
20-30% 1 year
-
5-year patency rate of saphenous vein graft
80-90%
-
best conduit for CABGs
internal mammary
-
solution that causes arrest of heart in diastole
potassium and cold solution cardioplegia
-
indications for CABG (3)
left main disease, LAD plus proximal left complications, 3-vessel disease (2-vessel in diabetics), 2-vessel disease plus proximal LAD and LVEF <50%, 1-2 vessel disease with stable angina, arrhythmia, or unstable angina
-
most common valve lesion
aortic stenosis
-
most common disease causing valve disfunction
rheumatic heart disease
-
good candidates for tissue valve
potential to become pregnant, contraindication to anticoagulation, frequent falls
-
contraindication to tissue valve
children/young patients, chronic renal dialysis
-
valvular lesion that can cause pulmonary congestion and mural thrombi
mitral stenosis
-
cardinal symptoms of aortic stenosis
angina, syncope, heart failure
-
most common site of prosthetic valve infections
aortic valve
-
most common site of native valve infections
mitral valve
-
patients who get right sided endocarditis
IV drug users
-
Most common organism causing endocarditis
S. aureus
-
Patients needing periprocedural endocarditis prophylaxis (5)
Prosthetic valve, rheumatic heart disease, congenital cardiac malformations, mitral valve prolapse, previous hx of endocarditis
-
Most common benign tumors of heart
Myxoma
-
Most common malignant tumor of heart
Angiosarcoma
-
Most common metastatic tumor of heart
Lung ca
-
Swelling of upper extremities and face, often secondary to lung cancer invading the SVC
Superior vena cava syndrome
-
Mediastinal tube output mandating re-exploration
>500cc/1st hour, >250cc/hr for 4 hours
-
risk factors for mediastinitis
use of bilateral internal mammaries, diabetes
-
disease with symptoms of fever, chest pain, SOB, and pericardial friction rub
postpericardiotomy syndrome
-
EKG findings of postpericardiomyotomy syndrome
Diffuse ST segment elevation
-
1st sign of tamponade on echo
decreased RA diastolic filling
|
|
