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Paediatrics > Cardiology > Flashcards

Cardiology Flashcards

1
Q

define ventricular septal defects (VSD)

A

a birth defect of the heart in which there is a hole in the wall (septum) that separates the two lower chambers of the heart

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2
Q

aetiology of VSD

A

septum dividing the left and right ventricle that fails to completely close - causes left to right shunting

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3
Q

clinical features of VSD

A

if small, often asymptomatic

if large: 
dyspnoea on exertion
poor weight gain 
tachypnoea 
failure to thrive
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4
Q

examination findings in VSD

A

pan-systolic murmur at left lower sternal border

systolic thrill

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5
Q

investigations of VSD

A

echocardiogram
CXR
ECG

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6
Q

management of VSD

A

if small:
self-resolve in 1yr
calorie intake increase
observations

if large/causing symptoms:
diuretics (e.g. captopril)
transvenous catheter closure
open heart surgery

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7
Q

additional requirements in VSD surgery

A

consider antibiotic prophylaxis to reduce risk of infective endocarditis

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8
Q

conditions commonly associated with VSD

A

Down’s Syndrome

Turner’s Syndrome

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9
Q

define atrial septal defect (ASD)

A

a cardiac malformation causing the hole between left and right atria that allows left-right shunting of blood

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10
Q

types of ASDs

A 
ostium secondum (failure  of septum secondum to close)
patent foramen ovular 
ositum primum (septum primum fails to close)
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11
Q

clinical features of ASDs

A

often asymptomatic but can present with:

dyspnoea
difficulty feeding
poor weight gain
recurrent LRTIs

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12
Q

examination findings in ASD

A

ejection systolic murmur in upper left sternal edge

fixed split second heart sound

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13
Q

management of ASD

A

refer to paeds cardiologist

if small: watching + waiting

if large: transvenous catheter closure or open heart surgery

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14
Q

additional requirements in ASD

A

provide anticoagulants (e.g. warfarin, aspirin and NOACs) to reduce clot and stroke risk

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15
Q

complications of ASD

A 
strokes (in context of DVT)
atrial fib/flutter 
pulmonary hypertension
Eisenmenger Syndrome 
right sided heart failure
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16
Q

define coarctation of the aorta

A

a narrowing of the aorta just before the ductus arteriosus causing diversion of blood into the brachiocephalic artery, constricting flow to distal branches supplying of the right leg

17
Q

conditions associated with coarctation of the aorta

A

Turners Syndrome:
XO karyotype
webbed neck
wide spaced nipples

18
Q

clinical features of coarctation of aorta

A

tachypnoea
poor feeding
greying and floppy baby
underdeveloped limbs

19
Q

examination findings in coarctation of aorta

A

systolic murmur below left clavicle and scapula
left ventricular heave
radio-femoral delay

20
Q

investigations of coarctation of aorta

A

CXR - rib notching appearance

echocardiogram

21
Q

management of coarctation of aorta (mild)

A

echo monitoring

22
Q

management of coarctation of aorta (severe)

A 
prostaglandin E (alprostadil)
stent insertion or surgical repair
23
Q

reasoning behind use of prostoglandin E (alprostadil) in coarctation surgeries

A

keeps ductus arteriosus open while waiting for surgery

24
Q

types of coarctation of aorta

A

preductal - before ductus

postductal - after ductus

25
Q

complications of coarctation of aorta

A

cerebral aneurysms due to triggering of renin-angiotension-aldosterone system

26
Q

define patent ductus arteriosus (PDA)

A

failure of ductus arteriosus to close after birth

27
Q

clinical features of PDA

A

dyspnoea
difficulty feeding
poor weight gain
LRTIs

28
Q

examination findings in PDA

A

continuous crescendo-decresendo ‘machinery’ murmur during 2nd heart sound
collapsing pulse
systolic thrill
bradycardia

29
Q

investigations in PDA

A

echocardiogram
doppler
CXR
ECG (if older)

30
Q

management of PDA (haemodynamically stable)

A

indomethacin - inhibits prostaglandin synthesis

31
Q

management of PDA (haemodynamically unstable)

A

trans-catheter

surgical ligation/closure

32
Q

define Tetralogy of Fallot

A

congenital condition of four existing pathologies:

VSD
overiding aorta
pulmonary valve stenosis
right ventricular hypertrophy

33
Q

risk factors of Tetralogy of Fallot

A

rubella infection
increased maternal age
alcohol consumption in pregnancy
diabetic mother

34
Q

clinical features of Tetralogy of Fallot

A

appearance of antenatal scans
Tet spells (acute cyanotic episodes with hypoxia, pain, crying and cyanosis)
poor feeding
poor weight gain

35
Q

examination findings in Tetralogy of Fallot

A

ejection systolic murmur

36
Q

investigations in Tetralogy of Fallot

A

echocardiogram
doppler flow studies
CXR - will show ‘boot shaped’ heart

37
Q

management of Tet spells in Tetralogy of Fallot

A 
knees to chest position
supplemental oxygen 
beta blockers 
morphine 
IV fluids 
sodium bicarbonate 
phenylephrine infusion
38
Q

management of Tetralogy of Fallot

A 
prostoglandin infusion (alprostadil) 
total surgical repair

Paediatrics (9 decks)

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