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Paeds > Cardio > Flashcards

Cardio Flashcards

1
Q

Harmless murmurs

A 
innoSent 
Systolic 
Soft 
L Sternal edge 
aSymptomatic
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2
Q

TOF
Overview

Features 
Signs and symptoms 
Findings 
Management 
Associations 
Complications
A 
4 features 
Pulmonary stenosis 
RVH
Overriding aorta 
VSD
Symptoms - CCCA 
Cyanosis 
Clubbing 
Collapse 
Acidosis 
Tet spells - white/blue and floppy after periods of exersion eg defication, crying, feeding 
Squatting sign 
Inconsolable crying

CXR - Boot sign
Ejection systolic murmur - ULSE

Management
Prostaglandins to maintain PDA
surgical repair @ 6 months

Complications 
MI 
CVA 
Endocarditis
CCF

Associations
Downs
Turners
DiGeorge

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3
Q

Findings of TOF

A

Ejection systolic murmur
Boot shaped heart on CXR
CCCA

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4
Q

TOGV

A

NO MURMUR
CCCA
Collapse on day 2 if PDA closes

Egg on side CXR

Management
Prostaglandins
Immediate surgical repair

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5
Q

What are the duct dependent lesions

A

CoA
HLHS
TOGV

Require immediate prostaglandin infusion to keep PDA open to survive
Or they will collapse when PDA closes (usually day 2)

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6
Q

Causes of congenital heart defects

A

DAD GINUS
Diabetes (maternal)
Alcohol
Drugs - SSRIs, RA, warfarin

Genetics 
Infection - rubella 
NCC dysregulation 
Unknown 
Syndrome - downs, digeorge, turners etc
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7
Q

Tricuspid atresia and HLHS

overview

A

cyanotic - R–>L

Rx T.A with blalock taussig shunt

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8
Q

PDA overview

Definition 
Symptoms 
Findings 
Management 
Complications
A

acyanotic
L–>R
Increased pulmonary flow

Definition: failure of the PDA to close in 1 month from the expected due date

Symptoms 
Tachypnoea
FTT 
Poor feeding 
Oedema 
Hepatomegaly

Machine murmur heard over the left clavicle
Thrill
Collapsing pulse
Gallop

CXR - the same for PDA/ASD/VSD

1) Increased pulmonary vasculature markings
2) Enlarged Pulmonary vessels
3) Cardiomegaly

Management
Close using indomethacin (NSAID)
Surgical ligation

Complications (same for ASD/VSD)

  • P. HTN
  • Eisenmengers
  • HF
  • Endocarditis risk
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9
Q

Main features of

1) Acyanotic
2) Cyanotic conditions

A

1) Acyanotic
Poor feeding
FTT
Tachypnoea

Cyanotic 
CCCA
Cyanosis 
Clubbing
Collapse 
Acidosis
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10
Q

VSD overview

A

Associations - downs, edwards, patau

Symptoms 
Tachypnoea 
FTT 
Poor feeding 
Wheeze 
HF

Findings
Small - loud pansystolic murmur LLSE + Quiet P2

Large - mid diastolic murmur - loud P2

CXR - the normal 3 for acyanotic

Management
small - spont closure
Large - diuretics and surgical closure

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11
Q

Common complications of ASD/VSD/PDA

A

P HTN
Eisenmengers
HF
Endocarditis risk ^

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12
Q

ASD overview

A

Associations - downs

Presentation 
tachypnoea 
poor feeding 
FTT 
Wheeze 
Recurrent chest infections 
arrhythmia in 4th decade
Investigations 
CXR - the normal 3 
ECG 
- Secundum - RBBB, RAD
- Primum - Superior QRS, neg AvF

Management

Cardiac catheterisation

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13
Q

CoA overview

A

Association - turners, digeorge

This is outflow obstuction in the sick child - it is a duct dependent lesion so the child will collapse on day 2 when PDA closes

Tachypnoea
Poor feeding
FTT

Intermittent claudication
Arterial HTN
SOB

Findings
Ejection systolic murmur Murmur heard best at the back - collaterals
RFD, RRD

CXR -
Rib notching
3 sign

Management
Prostaglandins
Surgical correction

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14
Q

Findings in CoA

A

Ejectio systolic murmur heard best at back
RDF/ RRD

3 sign 
rib notching (where collaterals are)
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15
Q

Aortic stenosis

A 
outflow obstruction in the well child 
Syncope 
Angina
Death 
Thrill

Ejection systolic murmur URSE
Downward T wave in V6

Management - balloon dilatation

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16
Q

Pulmonary stenosis

A

outflow obstruction in the well child

Ejection systolic murmur - ULSE
Thrill
Upward T in V1

Management - balloon dilatation

17
Q 
Endocarditis overview 
Cause 
Criteria 
Investigations 
Management 
Complications
A

Strep viridans

FROM JANE 
Fever
Roth spots
Osler nodes
Murmur - new
Janeway lesions 
Arthritis/ anaemia 
Nail haemorrhages 
Emboli

Investigations - DUKE
2 maj
1 maj 3 min
5 minor
Cirteria maj eg - blood culture evidence, endocardium ∆ on ECHO
Minr eg - fever, prev, RFs eg congenital heart disease,

Management
BenPen + Gent

Complications

  • MI
  • Pericarditis
18
Q

Rheumatic fever

A

Can come from scarlet fever

Strep throat pharyngitis infection -
STREP PYOGENES
–> rheumatic fever

JONES FACE P 
Joints - polyarthritis 
O - heart - myocarditis etc 
Nodules - subcutaneous 
Erythema marginatum
Sydenham chorea 
Fever
Arthralgia 
CRP/ESR
ECG ∆ - ^PR interval
Previous RF

Criteria (jones = major)
2 maj or
1 maj 2 minor

Investigations

  • Throat swab - strep pyogenes
  • ECG ∆
  • CXR - HR
Management 
Best rest 
Aspirin 
(Steroids if severe) 
Prolonged bacterial infection --> penicillin

Complications
Mitral stenosis

19
Q

Rx ASD

A

Cardiac catheterisation

20
Q

Management of aortic stenosis

A

balloon dilatation

same for pulmonary stenosis too

21
Q

Symptoms of endocarditis

A 
FROM JANE
Fever
Roth spots
Osler nodes
Murmur
Janeway lesions
Anaemia/ arthritis 
Nail haemorrhages 
Emboli
22
Q

Management of ASD

A

Cardiac catheterisation

23
Q

O/E findings of PDA

A

Machine murmur - heard best over the L clavicle
Collapsing pulse
Gallop
Thrull

Paeds (14 decks)

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