Finals

• Mitral valve prolapse


  Also known as Click-murmur Syndrome. Occurs when the flaps (leaflets) of the heart's mitral valve bulge (prolapse) like a parachute into the heart's left upper chamber (left atrium) as the heart contracts.
• Symptoms of mitral valve prolapse


  • Racing or irregular heartbeat (arrhythmia)
  • Dizziness or lightheadedness
  • Difficulty breathing or shortness of breath, often during physical activity or when lying flat
  • Fatigue
• Risk factors for mitral valve prolapse

  • Marfan syndrome
  • Ehlers-Danlos syndrome
  • Ebstein anomaly
  • Muscular dystrophy
  • Graves' disease
  • Scoliosis
• Diagnostic tests for mitral valve prolapse

  • Chest X-ray
  • Electrocardiogram
  • Stress test
  • Coronary Angiogram
• Medications for mitral valve prolapse

  • Beta blockers
  • Diuretics
  • Heart rhythm medication (Propafenone)
  • Aspirin
  • Blood thinner (Warfarin-Coumadin)
• Valve repair and replacement


  May be performed using open-heart surgery or minimally invasive surgery
• Tetralogy of Fallot


  Also known as Steno-Fallot Tetralogy. A congenital heart condition presenting a combination of four defects in the structure of the heart. The most common symptom is a bluish color of the skin in the newborn.
• Major defects in Tetralogy of Fallot

  • Pulmonary Stenosis
  • Right Ventricular Hypertrophy
  • Overriding Aorta
  • Ventricular Septal Defect
• Pulmonary stenosis


  Defect that occurs due to abnormal development of the fetal heart during the first eight weeks of pregnancy. Problems with the pulmonary valve make it harder for the leaflets to open and permit blood to flow forward from the right ventricle to the lungs.
• Right ventricular hypertrophy (RVH)


  A pathologic increase in muscle mass of the right ventricle in response to pressure overload. Symptoms are due to pulmonary hypertension, exertional chest pain, peripheral edema, exertional syncope, and right upper quadrant pain.
• Management of Tetralogy of Fallot

  • Diuretics
  • Oxygen
  • Anticoagulants
• Overriding aorta


  A congenital heart defect where the aorta is positioned directly over a ventricular septal defect, instead of over the left ventricle. The aorta receives some blood from the right ventricle, which reduces the amount of oxygen in the blood.
• Ventricular septal defect


  A hole in the wall that separates the heart's lower chambers. Occurs when the wall between the ventricles (lower chambers) is born.
• Signs and symptoms of Tetralogy of Fallot


  • A loud murmur
  • Cyanosis
  • Rapid breathing
  • Sudden drop of ABG
  • "Tetralogy Spell"
• Treatment of Tetralogy of Fallot

  1. Prostaglandin infusion

  2. Surgery - Corrective repair involves closure of the ventricular septal defect with a synthetic Dacron patch and enlargement of the pulmonary valve and right ventricular outflow tract
• Coarctation of the aorta


  A birth defect in which a part of the aorta is narrower than usual. If the narrowing is severe enough, the left ventricle may not be strong enough to push blood through the coarctation, resulting in a lack of blood to the lower half of the body.
• Risk factors for coarctation of the aorta

  • More common in males
  • Increased chance if another family member has it
  • Turner syndrome
• Signs and symptoms of coarctation of the aorta

  • Grouchiness
  • Pale skin
  • Sweating
  • Heavy or fast breathing
  • Enlarged liver (hepatomegaly)
  • Poor feeding or eating
  • Poor weight gain
  • Weak pulses in the feet, or no pulses in the feet
  • Blood pressure in the arms much higher than in the legs
  • Chest pain
  • Pain in lower legs with walking (claudication)
• Diagnostic tests for coarctation of the aorta

  • Chest X-ray
  • Electrocardiogram (ECG)
  • Echocardiogram
  • Cardiac catheterization
  • CT scan
  • MRI
• Management of coarctation of the aorta

  Cardiac catheterization - Putting a catheter through a blood vessel to the narrowed part of the aorta and inflating a balloon to stretch the area open. A stent may be placed to keep the aorta open.
• Patent ductus arteriosus (PDA)


  A persistent opening between the two major blood vessels leading from the heart. The opening (ductus arteriosus) is a normal part of a baby's circulatory system in the womb that usually closes shortly after birth. If it remains open, it's called a Patent Ductus Arteriosus.
• PDA allows a portion of oxygenated blood from the left heart to flow back to the lungs by flowing from the aorta, which has a higher pressure, to the pulmonary artery.
• Symptoms of PDA are uncommon at birth and shortly thereafter, but later in the first year of life there is an onset of increased breathing and failure to gain weight.
• An uncorrected PDA leads to pulmonary hypertension followed by right-sided heart failure.
• PDA is more common in premature newborns due to underdevelopment of the heart and lungs.
• Prostaglandins are used to keep the PDA open, and NSAIDs are not administered until surgical correction of the two defects is completed.
• Causes of congenital heart defects like PDA

  • Genetic factors
  • Problems early in the heart's development
• Diagnostic tests for PDA

  • Phonocardiograms
  • Echocardiography
  • Doppler studies
  • Electrocardiography (ECG)
  • Chest X-ray
• Risk factors for PDA

  • Premature birth
  • Family history and other genetic conditions
  • Rubella infection during pregnancy
  • Being born at a high altitude
  • Being female (PDA is twice as common in girls)
• Management options for PDA

  • Watchful waiting
  • Medications
  • Surgical closure
  • Catheter procedures
• Myocarditis


  An inflammation of the heart muscle (myocardium) that affects the heart muscle and the heart's electrical system, reducing the heart's ability to pump and causing rapid or abnormal heart rhythms (arrhythmias).
• Causes of myocarditis


  • Viruses (COVID-19, Hepatitis B and C, Parvovirus, Herpes Simplex Virus)
  • Gastrointestinal infections (Echovirus, Mononucleosis, German measles)
  • Bacteria (Staphylococcus, Streptococcus, Diphtheria, Lyme disease)
  • Parasites (Trypanosoma cruzi, Toxoplasma)
  • Fungi (Candida, Aspergillus, Histoplasma)
• Symptoms of myocarditis


  • Fever
  • Fainting
  • Difficulty breathing
  • Rapid breathing
  • Arrhythmias
• Diagnostic tests for myocarditis

  • Electrocardiogram (ECG)
  • Chest X-ray
  • MRI
  • Echocardiogram
  • Blood test
  • Cardiac Catheterization and Endomyocardial Biopsy
• Management of myocarditis


  • Avoid competitive sports for at least 3-6 months
  • Rest
• Medications for myocarditis


  • ACE Inhibitors (Enalapril, Captopril, Lisinopril, Ramipril)
  • Angiotensin II Receptor Blockers (ARBs)
• Myocarditis


  • Symptoms: Chest pain, shortness of breath, fatigue, fever, fluid around the heart
  • Causes: Viral infection, valve problems, blood clot in the heart
• Blood test


  Measures WBC and RBC counts, levels of certain enzymes that indicate damage to the heart muscle, also detects antibodies against viruses and other organisms that indicate a myocarditis-related infection
• Cardiac Catheterization and Endomyocardial Biopsy

  1. A small tube (catheter) is inserted into a vein in the leg or neck and threaded into the heart

  2. Doctors use a special instrument to remove a tiny sample of heart muscle tissue (biopsy) for analysis in the lab to check for inflammation or infection
• Management of Myocarditis


  • Avoid competitive sports for at least three to six months
  • Rest