Cardiac Flashcards
cardiac abnormalities associated with tetralogy of fallot
Pulmonary stenosis (ULSB), VSD at LLSB, overriding aorta, right ventricular hypertrophy
most common cause of congestive heart failure in the first year of life is?
VSD
s/s of Congestive EARLY heart failure in a 2-month old are?
Tachycardia and tachypnea
hepatomegaly, edema is initially noted in the eyes (can be subtle) about 10% wt increase.
what is the recommended sub acute bacterial endocarditis prophylaxis?
AHA recommends prophylaxis for children within 6 months of a surgical repair or catheterization procedure that left a closure device
OR (EASIER) children with repaired congenital heart disease with a residual effect.
URSB heard best when sitting, decreases with a change in head position, generally when turning ipsilaterally?
Venus Hum
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ipsilateral= same side
(contralateral= opp. side)
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heard best at ULSB, axilla, and back
Peripheral Pulmonary stenosis
Recommendations for children (2-8) with increased BMI and family risk factors
perform 2 lipid profiles and avg results
limit saturate fats <7%
t/f standard of care for high cholesterol for peds is statins
false, NO stating under 10 yrs
Murmur heard at URSB where is the problem likely coming from?
Aortic valve or Vessel
Murmur heard at ULSB where is the problem likely coming from?
pulmonic valve
pathologic murmur heard at LLSB where is the problem likely coming from? what else might you consider?
VSD or Tricuspid valve (even though tricuspid is on the RIGHT side of the heart, murmur is heard at Lower Left Sternal border)
grade 2 to 3/4 systolic ejection murmur heard at the ULSB concern for what kind of condition?
ASD
can be confused for pulmonary valve/artery problem but the question asked for systolic ejection NOT systolic ejection CLICK which is heard in stenosis
holosystolic murmur, sometimes associated with a thrill heard at the LLSB concern for what condition?
VSD
holosystolic murmur head at ULSB with a machinery sound concern for what condition
PDA
loud systolic ejection click at mid/ULSB concern for what condition?
TOF
hypercapnic hypercyanotic episodes are called? r/t what disorder?
TET spells
Prolonged PR interval on ECG with evidence of group A beta hemolytic strep is suspicious for?
Rheumatic fever
list some of the major Jones criteria for diagnosing rheumatic fever?(5) What are some of the minor? (4)
what is the diagnostic criteria?
major: subcataneous nodules, carditis, chorea, polyarthritis, erythema marginatum (erythema multiforme like rash, or lyme disease like rash)
minor: fever>102.2, elev CRP/sed rate, arthralgia, prolonger PR interval ECG with evidence of strep infection.
2 minor 1 major, or 2 minor 1 major
Venous hum decreases or disappears what two ways?
when turning head ipsilateral (right side), and when supine
what valve is most affected with rheumatic fever? which side is it?
Mitral- left side
which syndrome has coarctation of the aorta, bicuspid aortic valve
Turner syndrome
which syndrome has aortic regurgitation and mitral valve prolapse?
Marfan syndrome
Which syndrome is at risk for aortic dissection?
Marfan syndrome
acyanotic heart diseases?
cyanotic heart diseases?
obstructive heart diseases?
A- VSD, ASD, PDA
C- Tran of greater arteries, TOF
O- pulm stenosis, aortic stenosis, coarc
A= (think holes in heart) C= more extensive conditions TGA, TOF O= obstruction of valves
expected sounds and locations for TOF
LOUD systolic ejection CLICK @ mid and ULSB
pulm stenosis @ULSB
which condition has an ejection click at the apex and URSB if bicuspid valve is involved?
Coarctation
What do you expect to see for blood pressures in the 4 limbs of kids with a coarc?
higher pressure in upper
Lower pressure in bottom
TGA often has the same sounding murmur as what other condition?
VSD
which condition has a machine like quality? where do you hear this?
PDA at the ULSB
Where and what would you hear to make you suspect pulmonary stenosis?
ULSB, systolic ejection CLICK
also thrill at the ULSB radiating to back and side (PPS)
(click = think stenosis or narrow)
Where and what would you hear to make you suspect aortic stenosis?
systolic thrill at URSB, systolic ejection click.
click = think stenosis or narrow
What is the most common innocent murmur? where is it heard what does it sound like?
Stills murmur, between LLSB and apex
sounds musical, VIBRATORY
Venous hum is heard best at? sounds like?
URSB, continuous humming murmur
What is the flow of blood through the heart?
Sup vena cava, RA, Tricuspid valve, RV, Pulmonic valve, pulmonary artery, lungs, Pulm vein, LA, bicuspid/ mitral valve, LV, aortic valve, aorta, body= DONE :)
give yourself a hug that one is rough
S1 is the closure of?
Mitral and tricuspid valves (AV valves think atrioventricular as they separate the atrium and ventricles)
S2 is the closure of?
aortic/ pulmonic valves
Systole is the period between?
S1 and S2
diastole is the period between?
S2 and S1
describe the S/S for Kawasakis?
tx?
Fiery CRASH Fiery= Fever for 5days or more C= conjunctiva injected No exudate R= rash, appears polymorphic/ morbiliform, A= cervical lymphadenopathy S= Strawberry tongue H= hands, fingers edematous/ swollen then desquamation Tx: high dose ASA, IGG
Rib notching, cardiomegaly, grade 2-3 systolic ejection murmur, possible ejection click at URSB, what condition is this?
Coarctation of the Aorta
What are some red flags that concern you a patient is having chest pain related to cardiac symptoms?
Abrupt onset with no prodromal symptoms
frequent pain associated with activity or exertion
radiating pain, associated nausea, dizziness, fatigue
what are some signs and symptoms of chest pain that are likely not cardiac in origin?
sharp, stabbing pains along two or more costochondral joints, occurs at rest, short duration (seconds to few minutes)
what cholesterol level is considered hyperlipidemia?Borderline?
200= hyper 170-199 = borderline
what is the most useful test for eval of suspected rheum fever?
- ASO titer
- CRP
- EKG
- UA
ASO titer because it is important to evaluate for current or recent infection
Wolff-Parkinson white syndrome is associated with what cardiac disorder?
SVT
loud systolic ejection murmur heard at ULSB, holosystolic ejection murmur heard at LLSB with thrill. What condition are you concerned for?
TOF
Turner syndrome has what cardiac anomalies?
coarctation of the aorta and bicuspid aortic valve
Marfan syndrome has what cardiac anomalies?
mitral valve prolapse, aortic regurgitation and risk for aortic dissection
down syndrome often has what cardiac anomalie?
ASD/ VSD
List the 5 major jones criteria for diagnosis of rheumatic fever
(think P.E.C.C.S)
polyarthritis erythema marginatum carditis chorea subcutaneous nodules
