31. Congenital cardiac disease 1, 2, 3 Flashcards
Acyanotic diseases:
- ASD
- VSD
- PDA
- Coarctation of aorta
Cyanotic:
- Tetralogy of fallot
- Transposition of great vessels
Acyanotic and pulmonary blood flow conditions:
- ASD
- VSD
- PDA
Acyanotic and obstruction to flow from ventricles condition:
- Coarctation of aorta
Cyanotic and pulmonary blood flow condition:
Tetralogy of Fallot
Cyanotic and mixed blood flow conditions:
- Transposition of great arteries
Coarctation of aorta:
- Acyanotic
- Absent/weak femoral pulses
- Systolic BP high in upper body
- Harsh systolic murmur over back
Correction of coarctation of aorta:
- Surgery to prevent left ventricular dysfunction, but hypertension can still be present
VDS, ASD, PDA:
- Increased pulmonary blood flow
- May develop pulmonary hypertension
- Eventual reversal of shunt (Eisenmenger syndrome)
Ventricular Septal Defect:
- Commonest lesion in childhood
- Asymptomatic in small defect
- Poor growth, respiratory infections, heart failure with large defect
- Pansystolic, harsh murmur left sternum
- Enlarged heart & over-circulated lung fields
- Many will close spontaneously by age 7/8 year
Atrial Septal Defect:
- Asymptomatic, Clubbing!!!
- Possible dyspnoea on exertion
- Palpate right ventricle as it ‘lifts’
- Fixed split second heart sound
- May develop arrhythmias
Treatment for atrial septal defect:
- Closure via catheter or open surgery
Patent Ductus Arteriosus:
- Normally closes within first week
- Can persist in premature babies
- Asymptomatic if small
- Failure to thrive/heart failure if large
- Bounding pulses, wide pulse pressure
- Continuous murmur, louder in systole
Patent Ductus Arteriosus treatment:
Open or catheter closure
X ray shoe shaped heart sign:
Tetralogy of Fallot
4 features of tetralogy of Fallot:
- Pulmonary Stenosis
- Ventricular Septal Defect
- Overriding aorta
- Right ventricular hypertrophy
Tetralogy of Fallot:
- Most common cyanotic cardiac lesion
- Association with chromosome 22 deletions
- Failure to thrive with ‘milder forms’
- Critical feature is the degree of pulmonary stenosis
Genetic cardiomyopathy:
- Metabolic storage diseases
- Conduction defects
- Mitochondrial disorders
- Ion channel disorders
- Muscular dystrophies
Acquired cardiomyopathy:
- Myocarditis
- Stress-provoked
- Tachycardia-induced
- Infant of mother with diabetes
Kawasaki disease
- Acquired vasculitis
- Fever for at least 5 days
- And at least 4 of symptoms
Kawasaki disease symptoms:
- Red eyes
- Body rash (stomach, chest
- Sore irritated throat
- Swollen red, cracked lips
Heart failure signs and symptoms:
- Poor feeding
- Failure to thrive
- Tachypnoea/ Dyspnoea/ Wheezing
- Cyanosis
- Exercise intolerance
- Exertional dyspnoea
- Syncope
Significant heart failure signs:
- Symptomatic
- Pansystolic, diastolic murmur
- Loud, harsh
- Thrills
Red flags in heart failure:
- Lack of prodrome
- Palpitations, Chest pain
- Induced by exercise
- Past cardiac history
- Family history of early cardiac death, arrhythmia or sudden death
Investigations and management in heart failure:
- CXR (cardiomegaly, boot-shaped, pulmonary oedema)
- Cardiac ultrasound
- ECG (ventricular/atrial hypertrophy)
Management in heart failure:
- PDA: ibuprofen, paracetamol, surgical ligation
- Heart failure: diuretics, ACE inhibitors
- Surgery
- Nutritional support
Bounding pulses, wide pulse pressure:
Patent ductus arteriosus
Continuous murmur, louder in systole:
Patent ductus arteriosus
Pansystolic, harsh murmur left sternum:
Ventricular septal defect
Harsh systolic murmur over back sign:
Coarctation of aorta
Fixed split 2nd heart sound:
Atrial septal defect
