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Child Health > 4th Year Cardiology > Flashcards

4th Year Cardiology Flashcards

1
Q

what is a heave?

A

force pushes flat hand off the chest

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2
Q

what is a thrill?

A

palpable murmur

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3
Q

what is acrocyanosis?

A

hands and feet are blue

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4
Q

characteristics of murmurs

A 
timing= pulse, systolic/ diastolic/ continuous
location= 
intensity= graded 1-6
radiation
quality= soft, harsh, blowing
positional change
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5
Q

innocent murmur features

A 
physiological
soft
<3/6
short systolic
asymptomatic
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6
Q

what is an atrial septal defect (ASD)?

A

hole in the septum between the right and left atria

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7
Q

which way does blood shunt in an ASD?

A

left to right as pressure is higher on the left

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8
Q

what does an ASD cause to the right side of the heart?

A

enlarges atria, pulmonary artery and right ventricle

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9
Q

classification of ASD

A 
secundum= middle of the wall
primum= lower part of the septum
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10
Q

presentation of ASD

A

recurrent resp infections
fatigue post-feed
failure to thrive
SOB on exertion/ feeding

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11
Q

murmur in ASD

A

mid-systolic, crescendo-decrescendo murmur at the upper left sternal border with a fixed split of the 2nd HS

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12
Q

diagnosis of ASD

A

echocardiogram

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13
Q

management of ASD

A

surgery

pulmonary vasodilators to avoid Eisenmenger’s syndrome

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14
Q

VSD

A

blood flows from the left ventricle to the right

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15
Q

what does a VSD cause?

A

both ventricle enlargement, pulmonary artery and exposes pulmonary system to high pressure

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16
Q

presentation of small VSD

A

tends to be asymptomatic

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17
Q

medium/large VSD presentation

A

4-6 weeks with increased sweating during feeding
failure to thrive
fatigue post-feed
frequent resp infections

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18
Q

management of VSD

A

if large surgery, small tend to close without intervention

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19
Q

murmur in VSD

A

pansystolic left lower sternal border

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20
Q

what is an AVSD

A

lack of AV septum

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21
Q

classification of AVSD

A
  1. complete defect= common valve

2. partial defect

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22
Q

presentation of AVSD

A

blue
breathless
poor feeding
failure to thrive

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23
Q

diagnosis of ASVD

A

LV angiogram- goose neck

echo

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24
Q

what is AVSD associated with?

A

Down’s
heterotaxy syndrome
Kartagner’s

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25
presentation of coarctation of the aorta
poor feeding weak femoral pulses cyanosis
26
diagnosis of coarctation of the aorta
BP difference in arm/leg echo CXR
27
complications of coarctation of the aorta
berry aneurysms IE dissection under development of arm and leg
28
murmur in coarctation of the aorta
systolic?
29
management of coarctation
surgical repair= end-end resection or subclavian flap artoplasty balloon septostomy open heart surgery- cardiopulmonary bypass
30
four findings in tetralogy of Fallot
overriding aorta VSD RV outflow hypertrophy pulmonary valve stenosis
31
genetic associations with tetralogy of Fallot
T21 T18 T13 DiGeorge (22q11)
32
presentation of tetralogy of Fallot
``` cyanosis poor feeding failure to thrive SOB tets spell ```
33
shunt in tetralogy of Fallot
right > left causing cyanosis
34
RF for tetralogy of Fallot
rubella maternal age >40 alcohol during pregnancy diabetes
35
CXR finding in tetralogy of Fallot
boot shaped heart
36
what is a tets spell?
intermittent symptomatic periods of right to left becomes temporary worse causing a cyanotic episode happens when pulmonary vascular resistance increases or systemic vascular resistance decreases due to CO2 (vasodilator)
37
precipitants of tets spell
walking exertion crying
38
presentation of tets spell
irritable cyanotic SOB LOC
39
management of tets spell
squat/ bend knees to chest to increase SVR oxygen beta blockers to relax RV morphine decreases respiratory drive fluids sodium bicarbonate can buffer metabolic acidosis phenylephrine infusion increases SVR
40
what does the PDA become?
fossa ovalis
41
pansystolic murmur causes
mitral regurgitation tricuspid regurgitation VSD
42
MR murmur
pansystolic in 5th ICS MCL
43
tricuspid regurg murmur
pansystolic in 5th ICS left sternal border
44
ejection systolic murmur causes
aortic stenosis pulmonary stenosis HOCM
45
aortic stenosis murmur
ejection systolic 2nd ICS right sternal border
46
pulmonary stenosis murmur
ejection systolic 2nd ICS left sternal border
47
HOCM murmur
ejection systolic 4th ICS left sternal border
48
PDA murmur
continuous crescendo-decrescendo machinery murmur that makes the 2nd HS hard to hear
49
what does the murmur in tetralogy of Fallot come from?
pulmonary stenosis (ejection systolic in 2nd ICS left sternal border)
50
when does cyanosis occur?
when deoxygenated blood enters the systemic circulation as it bypasses the pulmonary circulation
51
heart defects that have cyanosis (right to left shunt)
VSD, ASD, PDA if develops Eisenmenger's | transposition of the great arteries
52
complications of ASDs
``` stroke AF atrial flutter pulmonary hypertension right-sided heart failure Eisenmenger's ```
53
management of ASD
transvenous catheter closure open heart surgery anticoagulation
54
which heart defect has increased risk of IE?
VSD
55
three conditions that can result in Eisenmenger's
ASD VSD PDA
56
what can make Eisenmenger's develop quicker?
pregnancy
57
management of eisenmeng'ers
``` impossible to reverse heart lung transplant sildenafil for pulmonary hypertension anticagoulation antibiotics ```
58
surgical options for aortic stenosis
percutaneous balloon aortic valvoplasty surgical aortic valvotomy valve replacement
59
management of pulmonary valve stenosis
balloon valvuloplasty via venous catheter
60
what is Ebstein's anomaly?
congenital heart condition where tricuspid valve is set lower in the right side of the heart causing a bigger RA and small RV leading to poor flow to pulmonary vessels
61
what is Ebstein's associated with?
ASD and WPW
62
presentation of Ebstein's
``` HF gallop rhythm cyanosis SOB poor feeding ```
63
management of Ebstein's
surgery
64
transposition of the great arteries
no connection between systemic and pulmonary circulation

Child Health (26 decks)

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