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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
Q

presentation of coarctation of the aorta

A

poor feeding
weak femoral pulses
cyanosis

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26
Q

diagnosis of coarctation of the aorta

A

BP difference in arm/leg
echo
CXR

27
Q

complications of coarctation of the aorta

A

berry aneurysms
IE
dissection
under development of arm and leg

28
Q

murmur in coarctation of the aorta

A

systolic?

29
Q

management of coarctation

A

surgical repair= end-end resection or subclavian flap artoplasty
balloon septostomy
open heart surgery- cardiopulmonary bypass

30
Q

four findings in tetralogy of Fallot

A

overriding aorta
VSD
RV outflow hypertrophy
pulmonary valve stenosis

31
Q

genetic associations with tetralogy of Fallot

A

T21
T18
T13
DiGeorge (22q11)

32
Q

presentation of tetralogy of Fallot

A 
cyanosis 
poor feeding
failure to thrive
SOB
tets spell
33
Q

shunt in tetralogy of Fallot

A

right > left causing cyanosis

34
Q

RF for tetralogy of Fallot

A

rubella
maternal age >40
alcohol during pregnancy
diabetes

35
Q

CXR finding in tetralogy of Fallot

A

boot shaped heart

36
Q

what is a tets spell?

A

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
Q

precipitants of tets spell

A

walking
exertion
crying

38
Q

presentation of tets spell

A

irritable
cyanotic
SOB
LOC

39
Q

management of tets spell

A

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
Q

what does the PDA become?

A

fossa ovalis

41
Q

pansystolic murmur causes

A

mitral regurgitation
tricuspid regurgitation
VSD

42
Q

MR murmur

A

pansystolic in 5th ICS MCL

43
Q

tricuspid regurg murmur

A

pansystolic in 5th ICS left sternal border

44
Q

ejection systolic murmur causes

A

aortic stenosis
pulmonary stenosis
HOCM

45
Q

aortic stenosis murmur

A

ejection systolic 2nd ICS right sternal border

46
Q

pulmonary stenosis murmur

A

ejection systolic 2nd ICS left sternal border

47
Q

HOCM murmur

A

ejection systolic 4th ICS left sternal border

48
Q

PDA murmur

A

continuous crescendo-decrescendo machinery murmur that makes the 2nd HS hard to hear

49
Q

what does the murmur in tetralogy of Fallot come from?

A

pulmonary stenosis (ejection systolic in 2nd ICS left sternal border)

50
Q

when does cyanosis occur?

A

when deoxygenated blood enters the systemic circulation as it bypasses the pulmonary circulation

51
Q

heart defects that have cyanosis (right to left shunt)

A

VSD, ASD, PDA if develops Eisenmenger’s

transposition of the great arteries

52
Q

complications of ASDs

A 
stroke
AF
atrial flutter
pulmonary hypertension
right-sided heart failure
Eisenmenger's
53
Q

management of ASD

A

transvenous catheter closure
open heart surgery
anticoagulation

54
Q

which heart defect has increased risk of IE?

A

VSD

55
Q

three conditions that can result in Eisenmenger’s

A

ASD
VSD
PDA

56
Q

what can make Eisenmenger’s develop quicker?

A

pregnancy

57
Q

management of eisenmeng’ers

A 
impossible to reverse
heart lung transplant
sildenafil for pulmonary hypertension
anticagoulation
antibiotics
58
Q

surgical options for aortic stenosis

A

percutaneous balloon aortic valvoplasty
surgical aortic valvotomy
valve replacement

59
Q

management of pulmonary valve stenosis

A

balloon valvuloplasty via venous catheter

60
Q

what is Ebstein’s anomaly?

A

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
Q

what is Ebstein’s associated with?

A

ASD and WPW

62
Q

presentation of Ebstein’s

A 
HF
gallop rhythm
cyanosis
SOB
poor feeding
63
Q

management of Ebstein’s

A

surgery

64
Q

transposition of the great arteries

A

no connection between systemic and pulmonary circulation

Child Health (26 decks)

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