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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?

Ventricular dilation Signup and view all the answers

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

Engorgement of the respective venous beds 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?

Due to the immature structure of the LV 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.