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Paeds > Cardio > Flashcards

Cardio Flashcards

1
Q

what causes a Left to right shunt and presentation?

A

breathless, VSD, ASD, PDA

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2
Q

what causes a right to left shunt and presentation?

A

BLUE. tetralogy of Fallot, transposition of the great arteries.

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3
Q

what causes a common mixing with breathless and blue

A

atrioventricular septal defect

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4
Q

what causes outflow obstruction in a well child- asymptomatic with a murmur

A

pulmonary or aortic stenosis

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5
Q

what causes outflow obstruction in a sick neonate presenting with collapse and shock

A

coarctation of the aorta

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6
Q

what causes the flap of foramen ovale to close

A

change in pressure- left atrial pressure increases and resistance to pulmonary flow decreases so increase of blood through lungs increases by 6 times

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7
Q

how is congenital heart disease found (presentation)

A

antenatal cardiac diagnosis, detection of a murmur, cyanosis, shock, heart failure

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8
Q

what are the signs of an innocent murmur

A

asymptomatic, soft blowing murmur, systolic, left sternal edge. and normal heart sounds, no parasternal thrill, no radiation

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9
Q

what is the presentation of heart failure

A

breathless, sweaty, poor feeding, chest infections. faltering growth, tachypnoea, tachycardia, murmur (gallop), enlarged hart, hepatomegaly, cool peripheries

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10
Q

causes of heart failure

A

neonates- obstruction to left heart; infants- L->R shunt; older children- Eisenmenger, cardiomyopathy

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11
Q

what causes cyanosis in the newborn

A

cardiac- cyanotic congenital heart disease; resp- surfactant deficiency, meconium aspiration; persistent hypertension of the newborn; infection- septicaemia; metabolic acidosis and shock

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12
Q

diagnosis congenital heart disease

A

ECHO, doppler, ECG, chest radiograph

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13
Q

causes of congenital heart disease

A

maternal- diabetes mellitus, rubella, SLE; maternal drugs- warfarin, fetal alcohol syndrome; chromosomal abnormalities- downs, pataus, edwards etc

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14
Q

what is the most common type of ASD

A

ostium secundum

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15
Q

what is the less common type of ASD

A

partial atrioventricular septal defect- ostium primum

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16
Q

what murmur is heard in both types of ASD

A

secundum- ejection systolic, primum- pansystolic

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17
Q

how does ASD present

A

commonly no symptoms, recurrent chest infections/wheeze, arrhytmias

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18
Q

what does the ECG show in ASD

A

secundum- RBBB and RAD, primum- deflected QRS in AVF

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19
Q

what are the signs in ASD

A

ejection systolic (secundum), split S2 due to the right ventricular volume being the same in inspiration and expiration, pansystolic (primum)

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20
Q

management in ASD

A

secundum- cardiac catherisation and occlusion device. primum- surgery. do it by age 3-5 years

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21
Q

what is there a problem with in ostium secundum

A

foramen ovale

22
Q

what does CXR show in ASD

A

cardiomegaly, enlarged pulmonary artery, increased pulmonary vasculature markings

23
Q

what size is a small VSD

A

smaller than aorta- less than 3mm

24
Q

symptoms of small VSD

A

asymptomatic, loud pansystolic murmur, quiet pulmomnary second sound

25
Q

management of small VSD

A

close spontaneously

26
Q

what size is a large VSD

A

same or bigger than aorta

27
Q

symptoms of large VSD

A

heart failure- breathless and failure to thrive; recurrent chest infections; tachypnoea, tachycardia, hepatomegaly; SOFT pansystolic murmur, loud P2

28
Q

CXR signs on large VSD

A

cardiomegaly, enlarged pulmonary arteries, increased pulmonary vasculature markings, pulmonary oedema

29
Q

what is a complication of large VSD

A

pulmonary hypertension, L to R shunt

30
Q

treatment of large VSD

A

diuretics, surgery at 3-6m to prevent Eisenmengers

31
Q

what is PDA

A

where the ductus arteriosus fails to close by 1 month

32
Q

when is PDA common

A

in pre term infants

33
Q

where is the defect in PDA

A

between the aorta and pulmonary artery, the blood flows from aorta into pulmonary artery so causing L-R shunt

34
Q

signs in PDA

A

continuous murmur beneath the left clavicle, collapsing/bounding pulse

35
Q

management PDA

A

close by coil or occlusion device by 1 year

36
Q

what happens to left ventricle in large left to right shunt

A

LVH

37
Q

what are the four problems in T of F

A

overriding aorta, large VSD, pulmonary stenosis, RVH

38
Q

what happens in transposition of the great arteries

A

aorta is connected to the right ventricle, pulmonary artery is connected to the left ventricle so blue blood goes to the body and pink blood goes back to the lungs

39
Q

when is transposition compatible with life

A

when there is some mixing- ASD, VSD,PDA

40
Q

symptoms transposition

A

cyanosis, usually presents day 2 when ductus arteriosus closes and leads to marked reduction in mixing of the blood, usually no murmur but may be a systolic murmur

41
Q

CXR in transposition

A

egg on side appearance

42
Q

management transposition

A

maintain patency of DA with prostaglandin. balloon atrial septostomy. surgery- transect pulmonary artery and aorta and switch them over

43
Q

what is Eisenmengers

A

high pulmonary blood flow and pulmonary hypertension due to large L to R shunt. leads to increased resistance and shunt reversal and the child is blue

44
Q

where is complete atrioventricular septal defect seen

A

children with Downs

45
Q

what are the features of complete atrioventricular septal defect

A

cyanosis at birth, breathless at 2-3 weeks of life

46
Q

what is the most common arrhythmia in childhood

A

SVT rapid HR of 250-300bpm

47
Q

what does SVT lead to and how does it present

A

leads to poor cardiac output and pulmonary oedema. presents with heart failure symptoms in neonates and young infants and hydrops fetalis and intrauterine death.

48
Q

why is SVT called re rentry tachycardia

A

circuit of conduction set up, premature activation of atrium via the accessory pathway

49
Q

what is the treatment in SVT

A

IV adenosine bolus- induces atrioventricular block. electrical cardioversion if this is unsuccessful

50
Q

mainenance therapy in SVT

A

fleicanide or sotalol. treatment stops at 1 year as more children wont have any further attacks

51
Q

signs of venous hum

A

continuous low pitched rumble beneath clavicle, increases on inspiration and louder after exercise, disappears when lying flat or compression of jugular veins on ipsilateral side

Paeds (16 decks)

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