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3A Paediatrics > Cardiac issues > Flashcards

Cardiac issues Flashcards

1
Q

What are the 2 things that exist in foetal circulation but not in normal circulation?

A

Foramen Ovale
Ductus arteriosus

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2
Q

What is the foramen ovale?

A

Patent foramen ovale (PFO) is a hole between the left and right atria (upper chambers) of the heart. This hole exists in everyone before birth, but most often closes shortly after being born. PFO is what the hole is called when it fails to close naturally after a baby is born.

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3
Q

What is the ductus arteriosus?

A

ductus arteriosus is a blood vessel that connects the pulmonary artery (main vessel supplying the blood to the lungs) to the aorta (main vessel supplying the blood to the body). This connection is present in all babies in the womb, but should close shortly after birth.

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4
Q

Why are the FO and DA important in a clinical context?

A

Foramen Ovale and Ductus Arteriosis can remain patent beyond initial neonatal period

In duct dependent lesions, this can assist survival

Explains why some lesions may not become apparent until a few weeks of age

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5
Q

What are the 3 broad categories of congenital heart disease?

A

Holes/connections
Narrowings
Complex

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6
Q

What happens in atrial septal defect?

A

Opening between atria

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7
Q

What are the clinical features of atrial septal defect?

A

Asymptomatic when younger
Fixed and widely split S 2
Ejection Systolic murmur in pulmonary area
Older children and adults get signs and symptoms: Fixed splitting ,ESM,Palpitations

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8
Q

What are the types of atrial septal defect?

A

Ostium Secundum

Ostium Primum

Sinus Venosus ASD

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9
Q

What is patent ductus arteriosus?

A

When there is a vessel connecting aorta and the pulmonary artery

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10
Q

What are the clinical features of patent ductus arteriosus?

A

Usually preterm babies

Poor feeding, failure to thrive tachypnoea

Active precordium,Thrill, Gallop rhythm

Classical continuous machinery murmur pulmonary area

Hepatomegaly,oedema

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11
Q

What happens in a ventricular septal defect?

A

Even large VSD’s may not present symptomatically until PVR has fallen

Poor feeding ,failure to thrive ,tachypnoea

Active precordium,Thrill ,Gallop rhythm

Pan systolic murmur best heard in LLSE transmits to upper sternal edge and axillae

Hepatomegaly ,oedema

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12
Q

What happens in an atrioventricular septal defect?

A

Theres an opening between ventricles

Underdeveloped leaflet of mitral and tricuspid valve

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13
Q

Clinical features of Atrioventricular septal defect

A

Common defect in Trisomy 21
Can lead more rapidly to Pulmonary Vascular disease so important to screen all children with down’s syndrome with Echocardiograms

Poor feeding ,failure to thrive, tachypnoea

Active precordium ,Thrill ,Gallop rhythm

Hepatomegaly ,oedema
Murmur arises from the valvular regurgitation rather than septal defects

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14
Q

What are the types of stenoses/ Narrowings?

A

Coarctation of the Aorta
Aortic Stenosis
Pulmonary Stenosis

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15
Q

What happens in coarctation of the aorta?

A

Narrowed aorta

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16
Q

Clinical features of coarctation of the aorta?

A

Weak femoral pulses

Always compare to brachials

Pre and post ductal difference in saturations(but only if duct open)

4 limb BP: Discrepancy between upper limb and lower limb blood pressure

Older children murmur over back (after collaterals develop)
If duct has closed/ is closing these babies present collapsed and acidotic

17
Q

What happens in aortic stenosis?

A

There is a thickened, narrow aortic valve

18
Q

What are the clinical features of an aortic stenosis?

A

Weak Pulses

Thrill palpable in suprasternal region and carotid area

Ejection systolic murmur in aortic area

If critical aortic stenosis then child presents collapsed and acidotic

19
Q

What happens in pulmonary stenosis?

A

Thickened pulmonary valve

20
Q

What happens in pulmonary stenosis

A

Ejection systolic Murmur in the Left Upper sternal edge

Murmur often radiates to the back especially if the pulmonary branches are also stenosed

Right Ventricular heave (if significant stenosis)

21
Q

What are some Common cyanotic heart conditions?

A

Transposition of the Great Arteries

Tetralogy of Fallot’s

22
Q

What happens in transposition of the great arteries?

A

There is an opening between atria

The vessels (aorta and pulmonary artery) are switched

VESSEL CONNECTING AORTA AND PULMONARY ARTERY

23
Q

What are the clinical features of transposition of the great arteries?

A

Depending on lesion,severity,age etc

Cyanosis

Acidosis

Collapse/ Death

24
Q

What happens in TOF

A

Look back at 2nd year notes

25
Q

Clinical features of TOF

A

Depending on lesion,severity,age etc

Cyanosis

Collapse

Acidosis

Check for 22q deletion

3A Paediatrics (19 decks)

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