Right to Left Heart Shunts
- The 5 Ts
- Truncus Arteriosus
- Transposition of the Great Vessels
- Tricuspid Atresia
- Tetralogy of Fallot
- Total Anomalous Pulmonary Venous Return (TAPVR)
- Cyanosis at Birth
- May Require PDA
Left-to-Right Heart Shunts
- The 3 Ds
- Ventricular Septal Defect (VSD)
- Atrial Septal Defect (ASD)
- PDA
- Later Cyanosis
- Clubbing
- Eisenmenger's Syndrome
Atrial Septal Defect (ASD)
- Hole in Septum between the Atria
- Often Asymptomatic
- Wide and Fixed Split S2
- Cyanosis and Dyspnea
- Easily Fatigued
- Chest X-ray shows Increased Pulmonary Vascular Markings
- Echocardiogram
- Surgery if CHF as Child
- Antibiotic Prophylaxis
- Most Close Spontaneously
Ventricular Septal Defect (VSD)
- Opening at Intraventricular Septum
- Most Common Congenital Heart lesion
- High-pitched Holosystolic Murmer (over left sternal border)
- Dyspnea and Respiratory Distress
- Loud Pulmonic S2
- Echocardiogram
- Small VSDs Close Spontaneously
- Large VSDs Require Surgery
- Endocarditis
- Eisenmenger's Syndrome
- CHF
Patent Ductus Arteriosus
- Continuous
- Machine like murmur
- Often Due to Congenital Rubella
- Prematurity
Persistent Truncus Arteriosus
- Common Arterial Trunk
- Single Trunk Emerges from Both Ventricles
- Cyanosis
- Pulmonary Congestion
- Heart Failure
- Single S2 Sound
- Echocardiogram
- Chest X-ray
- Early Surgical Correction
- Avoids Pulmonary Hypertension
Tetralogy of Fallot (TOF)
- Blue Baby Syndrome
- PROVe Acronym
- Pulmonary Infundibular Stenosis
- Right Ventricular Hypertrophy
- Overriding Aorta
- Ventricular Septal Defect (VSD)
- Boot-Shaped Heart
- Squatting for Tet Spells
- Surgery
Total Anomalous Pulmonary Venous Return (TAPVR)
- Pulmonary Veins Do Not Connect to Left Atrium
- Oxygenated Blood Return to Right Atrium
- Incompatible with Life without a Shunt
- Vessel Enters at an Acute Angle
- Severe Cyanosis
- Pulmonary Edema
- Delayed Manifestation (1 or 2 years)
- Right Heart Failure
- Chest X-ray Shows "Snowman"
- Echocardiogram
- Surgical Correction
Transposition of Great Vessels
- Pulmonary and Systemic Circulation are in Parallel
- Incompatible with Life Without a Shunt
- Severe Cyanosis at Birth
- Single S2 sound
- Echocardiogram
- Chest X-ray shows "Egg-shaped Silhouette"
- Prostaglandin
- Avoid NSAIDs
- Surgical Correction
- Balloon Atrial Septostomy
Coarctation of The Aorta
- Constriction of a Portion of Aorta
- Turner Syndrome
- Asymptomatic Hypertension
- BP Higher in Upper Extremities, Right Arm
- CHF
- Echocardiogram
- Cardiac Catheterization
- 3 Sign on Chest X-Ray
- Rib Notching
- Surgical Correction
Ebstein's Anomaly
- Displacement of Tricuspid Valve Leaflets
- "Atrialization" of the Right Ventricle
- Lithium Exposure In Utero
- Tricuspid Regurgitation
- Right-Sided Heart Failure
Tricuspid Atresia
- Absent Tricuspid Valve
- Incompatible with Life Without a Shunt
- Cyanosis at Birth
- Single S2 Sound
- Electrocardiogram (ECG)
- Echocardiogram
- Prostaglandin
- Avoid NSAIDs
- Surgical Correction
Hereditary Hemorrhagic Telangiectasia
- Autosomal Dominant
- Mutation in TGF-beta
- Nosebleed (Epistaxis)
- Telangiectasias
- GI Bleeding
- Hematuria
- AVM Formation
- Curaçao Criteria
- Genetic Testing
- High Output Heart Failure