Cardiac/Vascular Flashcards
What does a VSD sound like to auscultation?
A harsh blowing holosystolic murmur heard at the left lower sternal border that radiates over the precordium.
What heart defect can result in an infant with a mother with active SLE during pregnancy?
Heart block, which can be irreversible and can result in heart failure, need for early
pacemakers, and an increased incidence of early death.
What does a “boot-shaped” heart on chest x-ray indicate in a child?
Tetrology of Fallot
What heart sound is heard with an ASD?
A fixed split S2
What heart sounds are heard with a VSD
VSD commonly presents as a harsh or blowing holosystolic murmur best heard along the left lower sternum, often with radiation throughout the precordium.
How does Kawasaki disease present?
Kawasaki disease typically presents with prolonged fever, a polymorphous rash, extremity changes (including swelling in the early period of the illness with peeling from the fingertips coming later), nonpurulent conjunctivitis, lymphadenopathy, and oral mucosal changes including fissured lips and oropharyngeal mucosal erythema. There is typically an increase in platelets. Other clinical findings may include vomiting and diarrhea with abdominal pain, hydrops of the gall bladder, arthritis or arthralgias, irritability and aseptic meningitis. Coronary artery aneurysms can develop, as can aneurysms in other areas.
What is treatment for Kawasaki disease?
IVIG and high dose aspirin
How does myocarditis present?
Dyspnea, tachypnea, tachycardia, distant heart sounds, gallop, cardiomegaly on x-ray, echo showing dilated ventricles with poor ventricular function, and low voltage ventricular depolarization on EKG
What are the findings associated with Ebstein anomaly?
A quadruple rhythm associated with the murmur of tricuspid regurgitation and a middiastolic murmur at the lower left sternum suggests the diagnosis of Ebstein anomaly (downward displacement of the tricuspid valve). The presence of right atrial hypertrophy and right ventricular conduction defects confirms the diagnosis.
How does transposition of the great vessels with an intact ventricular septum present?
With early cyanosis, a normal-sized heart (classic “egg on a string” radiographic pattern in one-third of cases), normal or slightly increased pulmonary vascular markings, and an ECG showing right-axis deviation and right ventricular hypertrophy.
How does tricuspid atresia present?
Early cyanosis, causes diminished pulmonary arterial blood flow; the pulmonary fields on x-ray demonstrate a diminution of pulmonary vascularity, and left-axis and LVH are shown by ECG (due to relative atrophy of right ventricle).
What radiographic finding is seen with obstruction of pulmonary venous return?
Fluffy-appearing venous congestion (“snowman”) on chest x-ray
What cardiac defect is associated with Noonan syndrome?
Pulmonic stenosis
What cardiac defect is seen in Ehlers-Danlos syndrome?
Mitral valve prolapse
What symptoms may be seen in Henoch-Schönlein purpura (HSP)?
The purpuric rash most often involves extensor surfaces of the extremities, the lower legs, and the buttocks. Other significant symptoms include edema, arthralgia or arthritis, colicky abdominal pain with GI bleeding, acute
scrotal pain, and renal abnormalities ranging from microscopic hematuria to acute renal failure. As HSP is a systemic vasculitis, any organ system can be affected. The prognosis, however, is excellent unless there is end stage renal damage
