Cardiology Review

From Iusmicm

Contents 1 Cardiology Review 1.1 In Utero Circulation 1.2 Concepts 1.3 <Disorder> 1.3.1 Symptoms of <Disorder> 1.3.2 Signs of <Disorder> 1.3.2.1 Auscultation of <Disorder> 1.3.2.2 EKG of <Disorder> 1.3.3 Diagnosis of <Disorder> 1.3.4 Treatment of <Disorder>

Cardiology Review

In Utero Circulation

• The physiological differences in utero:
  • The pulmonary vessels are under large pressure (because there's no air in the lungs) so they have much higher resistance.
  • We don't need to get much oxygen to the lungs because it only has to supply the pulmonary tissue, not get oxygenated.
  • The blood coming into the right atrium is the oxygenated blood.
    • Recall that the oxygenated blood comes from the umbilicus which dumps into the IVC such that the right atrium receives half-oxygenated blood and half-non-oxygenated (from the SVC).

• What must be achieved by in utero circulation:
  • Both sides of the heart must pump blood so that the cardiac tissue can develop.

• In utero shunts as the solution:
  • So that the right heart can develop (pump blood) even in the face of very high pressures (resistance) in the pulmonary arteries, the ductus arteriosus allows blood leaving the right ventricle (via the pulmonary arteries) to shift to the aorta. The ductus arteriosus becomes the ligamentum arteriosus.
  • So that the left heart can develop (pump blood) even when there is very little return from the pulmonary veins (recall that there is high resistance and low flow in the in utero lungs), the formaen ovale allows blood to shift from the RA to the LA.

• Changes upon the first breath:
  • The resistance drops, the flow to the lungs increases, LA pressure increases as more blood is returned from the pulmonary tissue, the foramen ovale closes.
  • Increased pulmonary return at the LA results in increased pressure at the LV and the aorta, thus preventing shunting from R to L at the ductus arteriosus.

• In utero and adult structures:
  • Foramen Ovale: Fossa Ovalis
  • Umbilical Vein: Ligamentum teres
  • Ductus Arteriosum: Ligamentum arteriosum

• Here's a great explanation.
• Here's a simple explanation, too.

Concepts

<Disorder>

Symptoms of <Disorder>

Signs of <Disorder>

Auscultation of <Disorder>

EKG of <Disorder>

Diagnosis of <Disorder>

Treatment of <Disorder>