Congenital Heart Disease
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Questions and Answers

Which organ is not fully functional in a fetus?

  • Placenta
  • Liver (correct)
  • Heart
  • Lungs

    • What is the main function of the placenta in a fetus?

  • To provide oxygen and nutrients (correct)
  • To filter waste products
  • To produce red blood cells
  • To pump blood

    • Which blood vessel carries oxygenated blood from the placenta to the liver in a fetus?

  • Umbilical vein (correct)
  • Ductus venosus
  • Superior vena cava
  • Inferior vena cava

    • What is the pathway of most of the blood entering the right atrium (RA) in a fetus?

    <p>Through the tricuspid valve into the right ventricle (RV)</p> Signup and view all the answers

    What type of blood mainly enters the right atrium (RA) from the superior vena cava (SVC) in a fetus?

    <p>Deoxygenated blood</p> Signup and view all the answers

    Where does most of the well-oxygenated blood from the placenta enter in a fetus after reaching the right atrium?

    <p>Left atrium (LA)</p> Signup and view all the answers

    What is the purpose of the ductus venosus in a fetus?

    <p>To carry oxygenated blood from the inferior vena cava to the right atrium</p> Signup and view all the answers

    Which blood vessel carries deoxygenated blood from the head region of the fetus to the right atrium (RA)?

    <p>Superior vena cava (SVC)</p> Signup and view all the answers

    What does the foramen ovale connect in a fetus?

    <p>Right atrium (RA) and left atrium (LA)</p> Signup and view all the answers

    Which vessel does blood mainly flow through after leaving the pulmonary artery?

    <p>Descending aorta</p> Signup and view all the answers

    What happens to systemic vascular resistance (SVR) at birth?

    <p>It increases</p> Signup and view all the answers

    What happens to pulmonary vascular resistance at birth?

    <p>It decreases</p> Signup and view all the answers

    What is the result of the expansion of the lungs at birth?

    <p>Increased blood flow</p> Signup and view all the answers

    What happens to the resistance to blood flow in the lungs when they expand?

    <p>It decreases</p> Signup and view all the answers

    What happens to the right atrial pressure at birth?

    <p>It decreases</p> Signup and view all the answers

    What happens to the left atrial pressure at birth?

    <p>It increases</p> Signup and view all the answers

    What happens if the closure of the valve between the left and right atria does not occur?

    <p>Patent foramen ovale</p> Signup and view all the answers

    What causes the closure of the ductus arteriosus?

    <p>Increased oxygenation of blood</p> Signup and view all the answers

    Which structure prevents blood from flowing backwards from the left atrium into the right atrium in a fetus?

    <p>Small valve around Foramen Ovale</p> Signup and view all the answers

    What is the term used to describe the permanent closure of the foramen ovale?

    <p>Anatomical Occlusion</p> Signup and view all the answers

    What causes the closure of the ductus arteriosus?

    <p>Increased oxygenation of blood</p> Signup and view all the answers

    What is the term used to describe the failure of the ductus arteriosus to close?

    <p>Patent Ductus Arteriosus</p> Signup and view all the answers

    What is the main function of the placenta in a fetus?

    <p>Exchange of nutrients and waste products between the mother and fetus</p> Signup and view all the answers

    What happens to the systemic vascular resistance (SVR) at birth?

    <p>Decreases</p> Signup and view all the answers

    What happens to the resistance to blood flow in the lungs when they expand?

    <p>Decreases</p> Signup and view all the answers

    What happens to the right atrial pressure at birth?

    <p>Decreases</p> Signup and view all the answers

    What happens to the left atrial pressure at birth?

    <p>Increases</p> Signup and view all the answers

    Which type of congenital malformation is the most common at birth?

    <p>Ventricular Septal Defect</p> Signup and view all the answers

    What happens to ventricular septal defects (VSDs) over time, during childhood in most cases?

    <p>They close spontaneously during childhood</p> Signup and view all the answers

    What is the consequence of a large ventricular septal defect (VSD)?

    <p>All of the above</p> Signup and view all the answers

    What is the consequence of a persistent ostia/defect in atrial septal defects (ASDs)?

    <p>Left-to-right shunt</p> Signup and view all the answers

    What is the main consequence of a left-to-right shunt in atrial septal defects (ASDs)?

    <p>Pulmonary hypertension</p> Signup and view all the answers

    When do most cases of atrial septal defects (ASDs) become significant?

    <p>In adulthood</p> Signup and view all the answers

    What is the main purpose of surgical correction for atrial septal defects (ASDs)?

    <p>Prevent irreversible pulmonary hypertension</p> Signup and view all the answers

    Which of the following is true about congenital heart disease?

    <p>It accounts for 20-30% of all birth defects.</p> Signup and view all the answers

    What is the main function of the ductus venosus in a fetus?

    <p>To allow most of the portal blood to bypass the liver.</p> Signup and view all the answers

    What happens to the left atrial pressure at birth?

    <p>It increases.</p> Signup and view all the answers

    Where does most of the well-oxygenated blood from the placenta enter in a fetus after reaching the right atrium?

    <p>Left atrium</p> Signup and view all the answers

    What type of blood mainly enters the right atrium (RA) from the superior vena cava (SVC) in a fetus?

    <p>Deoxygenated blood</p> Signup and view all the answers

    Which vessel carries most of the portal blood in a fetus?

    <p>Ductus venosus</p> Signup and view all the answers

    When does most congenital heart disease arise?

    <p>During the third to eighth week of gestation</p> Signup and view all the answers

    What causes bluish skin (cyanosis) in a patient with a right-to-left shunt?

    <p>Venous blood bypassing the pulmonary circulation</p> Signup and view all the answers

    What initially happens in a left-to-right shunt in congenital heart disease?

    <p>Increased pulmonary blood flow</p> Signup and view all the answers

    What is the consequence of increased pulmonary blood flow in congenital heart disease?

    <p>Right ventricular hypertrophy</p> Signup and view all the answers

    What causes late onset cyanosis in congenital heart disease?

    <p>Left-to-right shunt reversing</p> Signup and view all the answers

    What is the most common type of congenital malformation?

    <p>Left to right shuts</p> Signup and view all the answers

    What happens to ventricular septal defects (VSDs) over time, during childhood in most cases?

    <p>They close spontaneously</p> Signup and view all the answers

    Which structure is responsible for shunting blood from the pulmonary artery to the aorta in fetal life?

    <p>Ductus arteriosus</p> Signup and view all the answers

    What happens to the ductus arteriosus after birth?

    <p>It constricts and closes</p> Signup and view all the answers

    What happens if the ductus arteriosus remains patent after birth?

    <p>High pressure in aorta forces oxygenated blood into the pulmonary artery</p> Signup and view all the answers

    What is the consequence of a patent ductus arteriosus after birth?

    <p>Volume and pressure overload in pulmonary vessels</p> Signup and view all the answers

    Which condition is characterized by a right-to-left shunt that recirculates venous blood back into the systemic circulation?

    <p>Tetralogy of Fallot</p> Signup and view all the answers

    What is the most common cause of a right-to-left shunt in congenital heart disease?

    <p>Tetralogy of Fallot</p> Signup and view all the answers

    What happens in tetralogy of Fallot if the obstruction is mild?

    <p>Left-to-right shunt</p> Signup and view all the answers

    What is the term used to describe the discordant connection of the ventricles to their vascular outflow?

    <p>Transposition of great arteries</p> Signup and view all the answers

    What happens if there is complete transposition of the great arteries?

    <p>Incompatible with postnatal life</p> Signup and view all the answers

    What is the purpose of a shunt in the context of transposition of great arteries?

    <p>To recreate a pathway for oxygenated blood to reach the systemic circulation</p> Signup and view all the answers

    What is the prognosis of a patient with a shunt-related congenital heart disease?

    <p>Depends on the degree of tissue hypoxia and the ability of the right ventricle to handle the load</p> Signup and view all the answers

    What is the narrowing or constriction of the aorta?

    <p>Coarctation of the aorta</p> Signup and view all the answers

    What are the two forms of coarctation of the aorta?

    <p>With a PDA and without a PDA</p> Signup and view all the answers

    What are the consequences of coarctation of the aorta without a PDA?

    <p>Hypertension in the upper body and weak pulse in the lower body</p> Signup and view all the answers

    What is the recommended treatment for coarctation of the aorta?

    <p>Surgical correction to expand or remove the coarctation</p> Signup and view all the answers

    What is the consequence of a large ventricular septal defect (VSD)?

    <p>LV hypertrophy and delivery of blood to the lower body</p> Signup and view all the answers

    What is the frequency rank of coarctation of the aorta among common anomalies?

    <p>Highest</p> Signup and view all the answers

    What are the symptoms of a patient with transposition of great arteries?

    <p>Poor weight gain and cyanosis</p> Signup and view all the answers

    What determines the severity of coarctation of the aorta?

    <p>The severity of the narrowing and the patency of the ductus arteriosus</p> Signup and view all the answers

    Study Notes

    Fetal Circulation

    • The liver is not fully functional in a fetus.
    • The placenta is responsible for oxygenation and nutrient supply to the fetus.
    • The umbilical vein carries oxygenated blood from the placenta to the liver in a fetus.

    Fetal Blood Flow

    • Most of the blood entering the right atrium (RA) comes from the inferior vena cava (IVC).
    • The ductus venosus carries oxygenated blood from the placenta to the liver.
    • The foramen ovale connects the right and left atria.
    • The ductus arteriosus connects the pulmonary artery to the aorta.

    Transition from Fetal to Neonatal Circulation

    • At birth, systemic vascular resistance (SVR) increases.
    • At birth, pulmonary vascular resistance decreases.
    • Expansion of the lungs at birth leads to increased oxygenation and decreased pulmonary resistance.
    • Right atrial pressure decreases at birth.
    • Left atrial pressure increases at birth.

    Congenital Heart Disease

    • The most common type of congenital malformation is ventricular septal defects (VSDs).
    • VSDs often close spontaneously over time during childhood.
    • Large VSDs can lead to pulmonary hypertension and right heart failure.
    • Atrial septal defects (ASDs) can cause left-to-right shunts, leading to increased pulmonary blood flow.
    • ASDs can become significant if the defect persists over time.
    • The main purpose of surgical correction for ASDs is to prevent complications.

    Ductus Arteriosus

    • The ductus arteriosus shunts blood from the pulmonary artery to the aorta in fetal life.
    • After birth, the ductus arteriosus normally closes.
    • If the ductus arteriosus remains patent after birth, it can lead to complications.

    Other Congenital Heart Defects

    • Tetralogy of Fallot is characterized by a right-to-left shunt that recirculates venous blood back into the systemic circulation.
    • Transposition of the great arteries is a condition where the ventricles are connected to the wrong great arteries.
    • Coarctation of the aorta is the narrowing or constriction of the aorta.
    • Coarctation of the aorta can lead to hypertension and heart failure if left untreated.

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    Description

    Test your knowledge on fetal circulation and the differences between fetal and post-natal infants. Learn about the functional inactivity of fetal lungs, the dependence on the placenta for oxygen and nutrients, and the unique role of the liver. Discover the changes in fetal circulation at birth and how oxygenated blood is transported.

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