Path Cardio Outline - TMedWeb

Path Cardio OutlineStenosisInfantile. Notice where bloodis blue and where it is redAdult. Notice there isonly oxygenated blood.OBSTRUCTIVE CONGENITAL DEFECTSThese are defects whereby there is an inappropriate closure or failure to open of one of the largervessels or valves. It creates an obstruction (a stenosis or other increase in resistance) that causesabnormal flow.Coarctation of the Aorta‐ Definitiono Narrowing or encroachment on the lumen of the aorta, either descending or ascending(meaning proximal or distal) to the major brancheso Increased resistance to left ventricular outflow and decreased perfusion to organssupplied distal to occlusion/stenosiso Coarctation with Patent Ductus = “Infantile”• Symptom onset is early in life, and is usually fatal• Coarctation is proximal to major branches, with patent ductus arteriosis• Oxygenated blood cannot get through the stenosisoStenosis• Deoxygenated blood gets around the stenosis through PDA, supplyingbrain and body with deoxygenated bloodCoarctation without Patent Ductus = “Adult”• Symptom onset is dependent on severity of stenosis, in childhood or evenadulthood, with coarctation distal to major branches• Significant hypertension in upper extremities because left ventricle suppliesthem well with oxygenated blood, but the lower half is “cut off”• Weak Pulses and hypotension in the lower extremities, revealed as intermittentpain (claudication) on excess movement of the legs• Collateral circulation through enlarged intercostals supplying organs distal tocoarctation, revealed as “rib‐notching” on chest X‐ray.‐ Commonalitieso Systolic murmur that may be a thrill (more likely in infantile)o Left Ventricular Hypertrophy from increased resistanceo Grafting, Ballooning, and surgery have good outcomes (remember Anatomy PBL)Pulmonary Stenosis and Atresia‐ Causeo Mild to severe obstruction of pulmonary valveo Can be isolated or occur with other abnormalities (Tetralogy of Fallot or TGA)‐ Morphologyo Right Ventricular Hypertrophy from increased resistanceo Pulmonary Artery Dilation from forceful stream through stenosed valveo If entirely atretic = must be ASD with PDA to maintain blood blow, RV is hypoplastico If with another disease, RV pressure is not translated to the valve, meaning rightventricular hypoplasia9 | O wl Club Review Sheets