cardio day 1

Question 1

Mcc bicuspid aortic valve

Answer 1

aortic stenosis

Question 2

Sx PFO:

Answer 2

Asymptomatic

Question 3

Dx PFO:

Answer 3

Echocardiogram with bubble study

Question 4

trmt PFO:

Answer 4

Antiplatelet or anticoagulation

Close it with surgery or transcatheter

Question 5

3rd MC CHD

Answer 5

asd

Question 6

sx asd

Answer 6

Exercise intolerance like dyspnea and fatigue, supraventricular arrhythmias, cyanosis, RHF, paradoxical embolus

Question 7

exam asd

Answer 7

Soft systolic murmur at 2nd left intercostal space from inc flow across pulm valve
Soft diastolic murmur from inc flow across tricuspid valve

Question 8

trmt asd

Answer 8

Antiplatelet or anticoagulation

Close it with surgery or transcatheter

Question 9

small vsd sx

Answer 9

Small L to R shunt
No LV overload
Systolic murmur
Risk for AV prolapse
Good prognosis

Question 10

moderate vsd sx

Answer 10

Range of sx- from nothing to congestive heart failure
Moderate LV overload
May have PAH

Question 11

large vsd sx

Answer 11

Large L to R shunt causing RV overload and PAH

Question 12

cause vsd

Answer 12

Mother DM or alcohol abuse

Question 13

overall sx vsd

Answer 13

Dyspnea on exertion, exercise intolerance, pansystolic murmur, palpable thrill, RV heave

Question 14

vsd trmt

Answer 14

CHF trmt, ATB for infective endocarditis, pulmonary vasodilators
Close it with surgery or transcatheter

Question 15

vsd Good prognosis if:

Answer 15

Normal LVS function
Small L to R shunt
Normal pulmonary pressures
No Sx

Question 16

CoA sx infants

Answer 16

pale skin, irritability, sweating, dyspnea, trouble feeding

Question 17

CoA sx adults

Answer 17

HTN, HA, muscle weakness, cold feet, nosebleeds, chest pain, CHF

Question 18

CoA exam

Answer 18

Systolic murmur, upper extremity HTN, delayed femoral impulses, corkscrew appearance of retinal arterioles
Diff BP in diff parts of the body

Question 19

CoA dx

Answer 19

ECG- LVH
CXR- rib notching, enlarged intercostal collaterals
Echo- asc aorta
MRI
Cath

Question 20

CoA trmt

Answer 20

Balloon angioplasty + stent or surgery

Question 21

More common in premies

Answer 21

pda

Question 22

MCC death is LV overload

Answer 22

pda

Question 23

Sx PDA

Answer 23

L to R shunt

Worse if PDA is larger- LV volume overload, exercise intolerance, dyspnea, peripheral edema, palpitations

Question 24

Dx PDA

Answer 24

Widened pulse pressure

Continuous machine like murmur at left 1st and 2nd intercostal space

Question 25

trmt PDA

Answer 25

Close Transcatheter or surgery closure

Question 26

sx TOF

Answer 26

Low blood O2 saturation causes hypoxic episodes/tet spells: Tachypnea, dyspnea, cyanosis, LOC, death

Question 27

exxam TOF

Answer 27

Cyanosis, clubbing, polycythemia, failure to thrive, bad growth, RV lift, systolic affection murmur at L upper sternal border

Question 28

dextro TGV?

Answer 28

RV pumps to the aorta and LV pumps to the pulmonary arteries
Deoxygenated blood in systemic circulation (leads to cyanosis)
Oxygenated blood in pulm circuit

Question 29

Levo TGV?

Answer 29

R and L ventricles are reversed & mitral and bicuspid valves are reversed

Question 30

sx dextro TGV?

Answer 30

Cyanosis

Question 31

sx Levo TGV?

Answer 31

Asymptomatic until adulthood (R ventricle can only pump to whole body as a baby)
RV hypertrophy
Risk for CHF
May have other defects too such as a R to L shunt and cause mild cyanosis

Question 32

trmt dextro TGV?

Answer 32

IV prostaglandin- keeps ductus arteriosis open (need shunting to live)