fetal circulation and congenital heart disease
•Pressure gradient L:R •Flow from L - R •May lead to RAH and RVH •Typically asymptomatic •Pulmonary HTN late finding
atrial septal defect
umbilical arteries carry _____ blood
deoxygenated
Begins to close within first day of life
ductus arteriosus
Directs blood from pulmonary artery to aorta
ductus arteriosus
is a short blood vessel that connects the pulmonary artery to the aorta in the developing fetus. It is normally open only in a developing fetus.
ductus arteriosus
This shunt effectively bypasses the liver
ductus venosus
a shunt that allows oxygenated blood in the umbilical vein to bypass the liver and is essential for normal fetal circulation. Blood becomes oxygenated in the placenta and travels to the right atrium via umbilical veins through the this, then to the inferior vena cava.
ductus venosus
Blood entering the RT atrium flows across this shunt into the LT atria (RT → LT shunt)
foramen ovale
an aperture in the muscular tissue between the left and right atrium that allows blood to cross the atria and bypass pulmonary circulation during fetal development
foramen ovale
•Narrowed lumen of the aorta •70-80% bicuspid Ao valve •Related to closure of the ductus arteriosus •Upper extremity hypertension •Weak lower extremity pulses •Cool mottled lower extremity skin
coarctation of the aorta
Blood ejected from LT heart is preferentially delivered to ____ and ___ extremities
head upper
fetal circulation has high or low cardiac output?
high
umbilical veins carry _____ blood
oxygenated
Continuous machinery type murmur of the upper LT sternal border
patent ductus arteriosus
This structure provides oxygen and nutrients to your growing baby and removes waste products from your baby's blood.
placenta
where does oxygenation occur in the fetus?
placenta
Ductus arteriosus remains patent due to active relaxation in the presence of what substance?
prostaglandin E2
High fetal ______ ______ resistance
pulmonary vascular
•Congenital narrowing of Pulmonary outflow tract
pulmonic stenosis
•Increase afterload of the RV •Incomplete ejection and RV output •RVH may lead to RAH
pulmonic stenosis
•WORST CASE: RAH and RA pressure may re-open the foramen ovale •Shunt RT - LT
pulmonic stenosis
•Most common cyanotic defect •Symptoms depend upon size of VSD and degree of pulmonary stenosis •Degree of cyanosis depends upon vessel resistance
tetralogy of fallot
Large VSD + overriding Aorta + pulmonic valve stenosis + RVhypertrophy
tetralogy of fallout
•Approximately 50% of blood delivered to the aorta reaches the placenta via two _____ _____
umbilical arteries
•Most common congenital heart abnormality: 25-30% •LT to RT shunting •As pulmonary resistance decreases, symptoms increase •LT sided Failure
ventricular septal defect
•Blood is oxygenated in _____ and returned via the singular ____ ____
villi umbilical vein
fetal circulation has ____ arteries and ____ veins
2 1
low oxygen tension in fetal circulation increases ____ oxygen binding
HgF
