Pathophysiology of Left-to-Right Shunts
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Questions and Answers

What is a characteristic of left-to-right shunts?

  • Blood flow is preferentially directed towards the systemic circulation
  • PBF is decreased
  • PVR is higher than SVR
  • PVR is lower than SVR (correct)

What is a consequence of a large left-to-right shunt and low PVR?

  • Decreased SVR
  • Decreased PBF
  • Increased cardiac work for the RV
  • Substantial increase in PBF (correct)

What is a result of excessive PBF in patients with left-to-right shunts?

  • Progressive elevation in SVR
  • Increased cardiac output
  • Decreased PVR
  • Progressive elevation in PVR (correct)

What is a complication of volume overload in patients with left-to-right shunts?

<p>Ventricular dilation (C)</p> Signup and view all the answers

What is a result of diastolic changes in patients with left-to-right shunts?

<p>Engorgement of the respective venous beds (C)</p> Signup and view all the answers

Why may large left-to-right shunts outstrip the capacity of the left side of the heart to maintain adequate systemic perfusion in infants?

<p>Due to the immature structure of the LV (B)</p> Signup and view all the answers

Study Notes

Left-to-Right Shunts

  • Occur when PVR is lower than SVR, directing blood flow preferentially towards the lungs
  • Result in increased PBF (pulmonary blood flow)

Pathophysiologic Problems

  • Congestion of the pulmonary circulation
  • Intravascular volume overload with increased cardiac work for the LV
  • Excessive PBF, resulting in progressive elevation in PVR

Volume Overload Consequences

  • Ventricular dilation, placing the heart at a mechanical and physiologic disadvantage
  • Reduced diastolic compliance
  • Engorgement of respective venous beds, producing signs and symptoms of clinical CHF (congestive heart failure)

Infant's Limited Capacity

  • Imature left heart structure limits its capacity to maintain adequate systemic perfusion in the face of large left-to-right shunts

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Description

Learn about the effects of left-to-right shunts on the circulatory system, including increased pulmonary blood flow, congestion, and volume overload consequences.

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