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CONGENITAL DEFECTS - Coggle Diagram

- - - - Increased flow through the pulmonary circulation results in hypertrophy of pulmonary vessels and pulmonary hypertension
      - Increased pulmonary resistance → reversal of shunt →late cyanosis (Eisenmenger syndrome) with right ventricular hypertrophy + polycythemia+ clubbing
    - - VSD: Ventricular Septal Defect
        
        MOST COMMON CONGENITAL
        HEART DEFECT
        Associated with alcohol fetal syndrome
        
        Size determines
        age at presentation
        
        Small asymptomatic
        and close spontaneously
        
        Large need surgery
        can lead to Eisenmenger syndrome.
      - ASD: Atrial Septal Defect
        
        Most common type is
        ostium secundum
        -90% of cases Associated with
        Down Syndrome
        
        Split S2
        on auscultation
        
        Increased blood in right heart delays
        closure of pulmonary valve
        
        Paradoxical emboli are an important complication.
      - PDA: Patent Ductus Arteriosus
        
        Associated with Congenital
        Rubella Shunting
        between the aorta and
        the pulmonary artery
        
        Asymptomatic at birth
        Continuous 'machine-like' murmur
        
        Tx: indomethacin to ↓↓PGE → PDA closure
        
        Can develope Eisenmenger syndrome, resulting in lower extremity cyanosis
        
        Normally shunts blood from the
        pulmonary artery to the aorta, bypassing the lungs
  - - - TRANSPOSITION OF
        THE GREAT VESSELS
        
        Characterized by:
        
        Pulmonary artery arising from the left ventricle
        & Aorta arising from the right ventricle
        
        Associated with maternal diabetes
        
        Early cyanosis: Pulmonary & systemic do not mix
        
        Creation of shunt (allowing blood to mix) after
        birth is required for survival.
        
        PGE can be administered to maintain a PDA
        until definitive surgical repair is performed
        
        Results in hypertrophy of the right ventricle
        and atrophy of the left ventricle
      - TRUNCUS
        ARTERIOSUS
        
        Characterized by:
        
        Single large vessel arising from both
        ventricles →Truncus fails to divide
        
        Associated with ASD
        
        Early Cyanosis
      - TETRALOGY OF FALLOT
        
        Boot-shaped heart on x-ray
        
        Characterized by:
        
        1) Stenosis of the right ventricular outflow tract
        2) Right ventricular hypertrophy
        3) VSD
        4) Aorta that overrides the VSD
        
        Early cyanosis
        
        Patients squat (increased arterial resistance decreases shunting and allows more blood to reach the lungs)
        
        Degree of stenosis determines
        the extent of shunting and cyanosis
      - TRICUSPID
        ATRESIA
        
        Characterized by:
        
        Valve orifice fails to develop; right ventricle is hypoplastic
        
        Associated with ASD
        
        Early Cyanosis
  - - - Associations:
        
        NOT associated with PDA
        
        Coarctation lies after
        (distal to) the aortic arch
        
        Associated with Bicuspid Aortic Valve
      - Hypertension in the upper extremities and hypotension with weak
        pulses in the lower extremities
      - Collateral circulation across the intercostal arteries; engorged arteries - 'notching' of ribs on x-ray
    - - Associated with PDA
        
        PDA
        
        Coarctation lies after (distal to) the aortic
        arch, but before (proximal to) the PDA
        
        Turner syndrome
      - Lower extremity cyanosis in infants-often at birth