> For the complete documentation index, see [llms.txt](https://thisispiggy.gitbook.io/my-wiki/llms.txt). Markdown versions of documentation pages are available by appending `.md` to page URLs; this page is available as [Markdown](https://thisispiggy.gitbook.io/my-wiki/01-step-1/cardiology/31-congenital-heart-disease.md).

# 31 Congenital Heart Disease

## Cyanosis

\[\_]\(central vs peripheral cyanosis. 5T's of central cyanosis)..

![](https://f001.backblazeb2.com/file/wikiFiles/ofTQQCD.jpg)

* central cyanosis: seen in congenital heart disease in babies
* warm extremities: perfused with warm blood, just not enough O2

![](https://f001.backblazeb2.com/file/wikiFiles/6SOUsu4.jpg)

* 5 T's

## Tetralogy

### Pathogenesis

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Cardiology/tetralogy%20of%20fallot%20pathogenesis/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/A9n7lVz.jpg)

* pic: aorta shifted to right, override ventricular septum with VSD, thick RV walls, stenotic PV 

![](https://f001.backblazeb2.com/file/wikiFiles/ARXrjJo.jpg)

* all abnormalities caused by infundibulum/conus arteriosus "monology of fallot"

![](https://f001.backblazeb2.com/file/wikiFiles/5CPlzzP.jpg)

* pic: white infundibulum moving towards RV, dragging aorta with it to cause aorta to override RV, also creating VSD

![](https://f001.backblazeb2.com/file/wikiFiles/audJjG2.jpg)

* restricts flow of pulmonary artery

![](https://f001.backblazeb2.com/file/wikiFiles/HrWZpnI.jpg)

* deoxygenated blood diverted away from lung to LV and systemic circulation
* pink tets: mild obstruction, less cyanosis

![](https://f001.backblazeb2.com/file/wikiFiles/1KkG31x.jpg)

### Symptoms

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Cardiology/tetralogy%20of%20fallot%20murmur,%20xray,%20symptoms%20improve%20how,%20exacerbation%20when/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/xsKPifx.jpg)

![](https://f001.backblazeb2.com/file/wikiFiles/algIHtp.jpg)

* boot shaped heart
* hypertrophic RV and apex misplaced

![](https://f001.backblazeb2.com/file/wikiFiles/zqWDXmq.jpg)

* knit femoral arteries when squatting

![](https://f001.backblazeb2.com/file/wikiFiles/gqi3mky.jpg)

## Truncus Arteriosus

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Cardiology/truncus%20arteriosus%20pathogenesis%20and%20characteristics/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/O4q1xP3.jpg)

* normally truncus divides into aorta or PA
* persists = common trunk
* mixing of blood = cyanosis

![](https://f001.backblazeb2.com/file/wikiFiles/8ylnXjz.jpg)

## Transposition of great vessels

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Cardiology/transposition%20of%20great%20vessels%202%20types,%20blood%20flow,%20association/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/8Evk4y2.jpg)

* switched aorta and PA

![](https://f001.backblazeb2.com/file/wikiFiles/QfZrF9Q.jpg)

* relative position normal

![](https://f001.backblazeb2.com/file/wikiFiles/leRQJNt.jpg)

![](https://f001.backblazeb2.com/file/wikiFiles/D4GmfUr.jpg)

* D transposition
* VSD: allow RV/LV mix
* PDA: allow Ao PA mix 

![](https://f001.backblazeb2.com/file/wikiFiles/bobajJv.jpg)

* rare variant
* RV fail from not being able to take aorta pressure

![](https://f001.backblazeb2.com/file/wikiFiles/xhguXwR.jpg)

* transposition most common

## Tricuspid Atresia

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Cardiology/tricuspid%20atresia%20pathogenesis%20and%20characteristics/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/YPxNVpV.jpg)

![](https://f001.backblazeb2.com/file/wikiFiles/qpPFY2Y.jpg)

* only case to be compatible with life
* 2 shunts to allow blood flow

## TAPVR

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Cardiology/TAPVR%20is,%20blood%20flow,%20result/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/Dzte6UJ.jpg)

![](https://f001.backblazeb2.com/file/wikiFiles/PIwt2Cs.jpg)

* mixed blood with low O2, cyanosis

## Ebstein's

\[\_]\(Ebstein's is, characteristics, cause, EKG)..

![](https://f001.backblazeb2.com/file/wikiFiles/CIFtEgG.jpg)

* cyanosis and HF from tricuspid regurge

![](https://f001.backblazeb2.com/file/wikiFiles/ZuD3VTT.jpg)

![](https://f001.backblazeb2.com/file/wikiFiles/Vk2kTvI.jpg)

## Pulmonary Atresia

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Cardiology/pulmonary%20atresia%20pathogenesis,%20symptoms,%20treatment/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/MlEADRI.jpg)

* in utero not a problem
* VSD: allows blood to exit ventricle

![](https://f001.backblazeb2.com/file/wikiFiles/qceGHde.jpg)

![](https://f001.backblazeb2.com/file/wikiFiles/y4KgBOx.jpg)

* keeps connection open

## Conotruncal Heart Defect

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Cardiology/conotruncal%20heart%20defect%20is,%20disease/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/HDrhI12.jpg)

* arteriosus: form outflow of LV and RV
* classic: DiGeorge, develop any conotruncal problems

## Coarctation

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Cardiology/coarctation%20of%20aorta%20pathogenesis,%202%20types/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/XuBj4wJ.jpg)

![](https://f001.backblazeb2.com/file/wikiFiles/bhORpqT.jpg)

* preductal: before ductus arteriosus insertion

### Preductal

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Cardiology/preductal%20coarctation%20result,%20symptoms/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/oHE5Th6.jpg)

* DA supplying lower body = no need for collateral vessel development in womb

![](https://f001.backblazeb2.com/file/wikiFiles/GpO5VPj.jpg)

* cyanosis: blood bypass lung via DA and to lower extremities

![](https://f001.backblazeb2.com/file/wikiFiles/YNxOMrC.jpg)

* all blood has to go through narrowing
* baby into heart failure/shock in day 2 of life

![](https://f001.backblazeb2.com/file/wikiFiles/ocIkYry.jpg)

![](https://f001.backblazeb2.com/file/wikiFiles/Lb2UVXB.jpg)

* narrowing of aorta usually in thoracic region

### Postductal

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Cardiology/postductal%20coarctation%20result,%20symptoms,%20complications/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/mW3ieYh.jpg)

* good: no HF in babies
* bad: asymptomatic until adult

![](https://f001.backblazeb2.com/file/wikiFiles/ogQXZ2T.jpg)

* delay between when feel brachial vs femoral pulse

![](https://f001.backblazeb2.com/file/wikiFiles/ukHpMWb.jpg)

* young person with htn
* rarely, poor blood flow to lower body: pain/ischemia with walking

![](https://f001.backblazeb2.com/file/wikiFiles/KvTko41.jpg)

![](https://f001.backblazeb2.com/file/wikiFiles/hxKSerF.jpg)

* xray: aortic knob and below

![](https://f001.backblazeb2.com/file/wikiFiles/dtVgJSC.jpg)

* not flushed in upper extremities or cyanotic in lower extremities because of autoregulation

![](https://f001.backblazeb2.com/file/wikiFiles/v96MDI7.jpg)

* endovascular infection: infection inside vascular tree
* endocarditis: heart valves
* endarteritis: artery

[\_](https://github.com/thisispiggy/my-wiki/tree/601ff771dc2fac1318ae8b59435ac8485628fd81/01%20Step%201/Cardiology/coarctation%20of%20aorta%20associations/README.md)..

![](https://f001.backblazeb2.com/file/wikiFiles/2rZHnMP.jpg)

![](https://f001.backblazeb2.com/file/wikiFiles/jnSFqth.jpg)

* coarctation part of a bigger problem of vasculature