Cardiac wink winks Flashcards
What are formed from the mesodermal cells?
2 longitudinal cell clusters known as angioblastic cords
When in development does the heart begin to beat?
Day 22-23
1 mo becomes recognizable as heart and not just cords
When do the four chambers form?
28 days
When do the septa and chordae tendinae form?
8 wks
What does the umbilical cord consist of?
2 umbilical arteries
1 umbilical vein
What do the umbilical arteries do?
Take deoxygenated blood away from fetus
Goes through placenta to mom to oxygenate
What does the umbilical vein do?
Carry oxygenated blood back to baby
Foramen ovale
Flap that passes blood from right atrium to left atrium
Ductus arteriosus
Passes blood from pulmonary artery to aorta
What is the general cause of blue baby syndrome?
Ductus arteriosus or foramen ovale not closing properly
Eisenmenger syndrome
When a left-to-right shunt eventually forces the direction to reverse, causing right-to-left flow to supervene accompanied by the physical findings of hypoxemia and cyanosis
What is the most common cyanotic congenital heart dz after infancy?
Tetralogy of Fallot
What will be seen on CXR in tetralogy of Fallot?
Boot-shaped heart
What is tx for Tetralogy of Fallot?
Subacute bacterial endocarditis prophylaxis for life
Surgical repair
What is seen on CXR in transposition of great arteries?
Egg on a string
String is aorta and pulmonary artery
What is the 1st line tx for transposition of the great arteries?
Prostaglandin E
Prostaglandins keep shunts open
What is the first line tx for tricuspid atresia?
Prostaglandin E
S/sx of truncus arteriosus
Bounding peripheral pulses Single S2 (single valve)
Generalized trends of total anomalous pulmonary venous return (TAPVR)
Sx depend on obstruction of pulmonary venous drainage
-More cyanosis with obstruction
What is the most common cause of cardiac death in the first month of life?
Hypoplastic left heart syndrome
Tx for hypoplastic left heart syndrome
Prostaglandin E
Surgery
-Initial Norwood procedure
-Bidirectional Glenn and Fontan procedure
What is the MC congenital heart defect?
VSD
What is the MC VSD?
Perimembranous
What can a VSD be associated with?
MI
Down syndrome
What is the MC ASD?
Secundum
What is the #1 cause of widened pulse pressures?
Aortic regurgitation
What are the continuous murmurs?
PDA
Pericardial friction rub
Venous hum
What is a sign of coarctation of the aorta?
Decreased femoral pulses
Low BP to anything distal of the coarctation, high BP to anything proximal of the coarctation
What are the three signs of coarctation of the aorta?
Cardiomegaly, RVH, pulmonary edema
Rib notching
1st line tx of coarctation of aorta
Prostaglandin E1
Cardiac defect characteristic of DiGeorge syndrome
Tetralogy of Fallot
What is considered nl BP in peds?
Both systolic and diastolic BP <90th percentile
Pediatric HTN
Either systolic and/or diastolic BP greater than or equal to 95th percentile measured on 3 or more separate occasions
Stage 1 HTN- peds
Systolic and/or diastolic BP between the 95th percentile and 5 mmHg above the 99th percentile
Stage 2 HTN- peds
Systolic and/or diastolic BP greater than or equal to 99th percentile plus 5 mmHg
Tachycardia and flushing goes with…
Coarctation of aorta
Seen with HTN
Edema and elevated serum creatinine goes with…
Renal artery stenosis
Seen with HTN
EKG findings in sudden cardiac arrest (SCA)
ST elevation more than 2 mm
ST depression >0.5 mm
T wave inversions
What is congenital long QT syndrome associated with?
Increased risk of torsades de pointes
Criteria for congenital long QT syndrome
> 0.44 sec
How loud do diastolic murmurs get?
Only up to grade 4
General characteristics of innocent murmurs?
Grade less than or equal to 2
Softer intensity when the pt is sitting compared with when the pt is supine
Short systolic duration (not holosystolic)
Minimal radiation
Musical or vibratory quality
What is the most common innocent murmur of early childhood?
Still murmur
Loudest in supine position
Venous hum
Continuous musical hum usually heard after age 2
Best heard with the sitting position
