Cardiology Flashcards
Which paediatric heart defects present as Acyanotic?
Atrial Septal Defect
Ventricular Septal Defect
Combined Atrioventricular Septal Defect
In an Atrial Septal defect, which direction does blood flow?
Left to Right
What are the Subtypes of ASD?
Patent Foramen Ovale Ostium Primum defect Ostium Secundum defect Sinus Venous defect Coronary Sinus defect
What are some risk factors for development of an ASD?
Maternal DM Maternal Rubella infection Drug use Smoking Congenital syndromes
What are some symptoms of an ASD?
Asymptomatic
Tachypnoea
Poor weight gain
Recurrent chest infections
On Auscultation, which murmur may be heard with an ASD?
Soft Ejection Systolic murmur
Split S2
How should a suspected cardiac defect be investigated?
Echocardiogram
How can a confirmed ASD be managed?
Surgical closure if >1cm
Medical management if presents with HF
Monitor if Adult
What are some complications of ASD?
Arrythmia Pulmonary Hypertension Eisenmenger Syndrome Cyanosis Peripheral Oedema TIA/Stroke
What is Eisenmenger syndrome?
Chronic shunting of blood via a septal defect leads to Pulmonary Hypertension
In a VSD, which direction is blood shunted?
Left to Right
What are some risk factors for development of a VSD?
Maternal DM Rubella Fetal Alcohol Syndrome Maternal PKU Family history Congenital - Down Syndrome
How may a small VSD present?
Mild/Asymptomatic
How may a moderate VSD present?
Sweating
Fatigue
Tachypnoea
How may a large VSD present?
SOB
Feeding issues
Cyanosis if develops Eisenmenger’s syndrome
Which murmur may be heard on auscultation of VSD?
Pansystolic, Early Systolic murmur
What is the recommended immediate management of a VSD?
Diuretics
ACEi
Digoxin
What is the definitive management for a VSD?
Surgical repair
What are some potential complications of an untreated VSD?
Heart Failure Growth Failure Eisenmenger's Syndrome Endocarditis Arrhythmia Sudden death
What is an AVSD?
Defect of the AV septum leads to mixing of blood
What are some symptoms of an AVSD?
Tachypnoea Tachycardia Poor feeding Sweating Failure to thrive
Which investigations are appropriate for a suspected AVSD?
CXR - ?Cardiomegaly
Echocardiogram
What are medical management options for a confirmed AVSD?
Diuretics
ACEi
Digoxin
Adequate calorie intake
What is the definitive management of an AVSD?
Surgical repair
What are some potential complications of an AVSD?
Failure to thrive Recurrent LRTIs Congestive HF Pulmonary vascular disease Eisenmenger's
What is the most common cause of Cyanosis in a newborn?
Transpotision of the Great Vessels
With Transposition of the Great Vessels, what must be present in order for the child to survive?
Mixing of blood, which can be due to ASD, VSD or a PDA
What are some risk factors for developing Transposition of the Great Vessels?
Maternal Age >40 Maternal Diabetes Maternal Rubella infection Poor Nutrition Maternal alcohol consumption
What are some symptoms of Transposition of the Great Vessels?
Cyanosis within 24h of birth
Signs of congestive HF within 6w
What are some of the management options for confirmed Transposition of the Great Vessels?
Emergency Prostaglandin infusion
Correct Metabolic acidosis
Emergency Atrial Baloon Septoplasty
Surgical correction
What are some potential complications of Transposition of the Great Vessels?
Neopulmonary Stenosis
Neoaortic Regurgitation
Neoaortic Root Dilatation
Coronary Artery Disease
Which is the most common Congenital Heart defect?
Tetralogy of Fallot
What 4 things are present in Tetralogy of Fallot?
- Pulmonary Stenosis
- RV Hypertrophy
- VSD
- Overriding Aorta
How does Tetralogy of Fallot present?
Cyanosis - Lips and Fingertips Clubbing in fingers and toes Feeding difficulty Failure to gain weight Failure to develop normally
What may be seen on a CXR with Tetralogy of Fallot?
Boot-Shaped Heart
How should Tetralogy of Fallot be managed?
Surgical closure of the septal defect and enlargement of the RV outflow tract
What happens in a “Tet Spell”?
Increased O2 demand increases cardiac output thereby giving greater Cyanosis
How should a Tet Spell be managed?
Promote Vagal maneuvres such as squatting down
