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Cardio II: Congenital + Valvulopathy Cheat Sheet by

Cardiology

Cyanotic Congenital Heart Anomalies

Pulmonary Atresia
Pulmonary valve closed, ASD and PDA present, intact ventri­cular septum
Transp­osition of the great vessels
Complete transp­osition of the aorta and pulmonary artery
Hypopl­astic left heart syndrome
Small left ventricle, normal great vessels
Tetralogy of Fallot
Subaortic septal defect, right ventri­cular outflow obstru­ction, overriding aorta, right ventri­cular hypert­rophy

Acyanotic Congenital Heart Abnorm­alities

ASD
Opening between the left and right atria. Ostium secundum most common.
VSD
Opening between the left and right ventricle. **Most common of all congenital defects.
AV Septal Defect (Canal)
Due to incomplete fusion of the endoca­rdial fusions. Common in Down Syndrome.
PDA
Failur­e/delay in closure of the channel bypassing the lungs (which during fetal develo­pment allows placental gas exchange)
Coarct­ation of the Aorta
Narrowing in the proximal thoracic aorta
 

Aortic­/Mitral Valvular Disorders

Aortic Stenosis
Narrowing of the valve opening
Aortic Insuff­iciency (Regurg)
Results in volume overload of left ventricle
Mitral Stenosis
Impedes blood flow between the left atrium and left ventricle
Mitral Insuff­iciency
Causes backflow and volume overload of left atrium
Mitral Valve Prolapse
Can range from asympt­omatic to causing mitral regurg.
Conseq­uence of calve-­related heart failure
Pulmonary HTN + congestion
Most common cause of mitral­/aortic valve disorders
Congenital defects* (also rheumatic heart disease, infix)
Clinical scenario: female with minor chest wall deformity, mid systolic click, late systolic murmur
Mitral valve prolapse
Treatment
surgical repair, valve replac­ement, and balloon valvul­oplasty
Recomm­end­ations
Antico­agu­lation therapy esp. if pt. has Afib, and abc to prevent enocar­ditis if regurg.

Tricus­pid­/Pu­lmonic Valve Disorders

Right-­sided pressure overload leads to:
Right-­sided cardio­megaly, systemic venous conges­tion, and right-­sided heart failure
Clinical features
Exercise intole­rance, JVD, peripheral eema, hepato­megaly
EKG Findings
Right-axis deviation
Echo Findings
Definitive method for identi­fying struct­ura­l/f­unc­tional abnorm­alities
Treatment
Na+ restri­citon, diruteic therapy --> decrease fluid volume and right atrial filling pressure
               

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