Cardiology Flashcards
Types of VSDs
Perimembranous
- next to tricuspid valve
Muscular/ Trabecular
- Surrounded by muscle
Risk factors for VSD
Down’s syndrome
Turner syndrome
Foetal alcohol syndrome
Mumur in VSD
Pansystolic murmur
- Loudest in tricupid region
Systolic thrill
An _______ murmur can be heard in large VSDs due to an increased flow over mitral valve
Apical mid-diastolic murmur
ECG findings in VSD
In large VSD
- Biventricular hypertrophy
Management of small VSDs (<3mm)
Monitoring
- Echo
- ECG
- Auscultation
Preventing endocarditis
- Dentition
- Avoiding needles.
Large VSDs management
Surgery from 3-6 months
- Transvenous catheter closure
Heart failure
- Diuretics
- Captopril
_______ is a type of ASD involving deficiency of the foramen ovale and surrounding septum
Secundum
- Most common ASD
________ is a type of ASD involving deficiency in the AV septum
Atrial ventricular septal defect/ Primum
Presentation of ASDs
Recurrent chest infections/ wheeze
Murmurs
Murmurs in ASD
Ejection systolic
- left upper sternal edge (pulmonary)
Fixed, widely split S2
Apical pansystolic mumur
- AVSD (AV regurgitation)
Chest X-ray findings of ASD
Cardiomegaly
Pulmonary artery hypertrophy
Increased pulmonary vascular markings
ECG findings for ASDs
Secundum
- Right axis deviation- due to RV enlargement
- pRBBB
Partial AVSD
- Superior axis= negative deflection in aVF
Management of ASD
Secundum
- Occlusion devise
Partial AVSD
- Surgery
Ductus arteriosis is expected to close up ______ after birth
1 months
Eisenmenger syndrome
Right to left shunt that occurs due to increased pulmonary vascular resistance
- Decompensation after left-to-right shunt
A ________ pulse can be seen in a patent ductus arteriosus due to an increased _______
Collapsing/ bounding pulse
Increase pulse pressure
Murmur in PDA
Crescendo-decrescendo murmur in S2
- Upper left sternal edge
What investigation provides definite diagnosis for PDA
Echocardiogram
What investigation provides definite diagnosis for PDA
Echocardiogram
Indications of surgical closure of PDA
Age > 1
Symptomatic
Heart failure
Indications of surgical closure of PDA
Age > 1
Symptomatic
Heart failure
7 S’s of innocent mumurs
Soft Symptomless Systolic Short Situation dependent (quieter when standing) Normal S1 and S2
Normal special tests
Risk factors for innocent murmurs
Febrile illness
Anaemia
A mitral regurgitation murmur is heard in the _____ area and is a _______ murmur
Mitral area (5th IC space, mid-clavicular)
Pan systolic murmur
A tricuspid regurgitation murmur is heard in the _____ area and is a _______ murmur
Lower left sternal edge (5th IC, sternal border)
Pansystolic murmur
An aortic stenosis murmur is heard in the _____ area and is a _______ murmur
2nd IC space, right sternal border
Ejection systolic
A pulmonary stenosis murmur is heard in the _____ area and is a _______ murmur
2nd IC space, left sternal edge
Ejection systolic
A hypertrophic obstructive cardiomyopathic murmur is heard in the _____ area and is a _______ murmur
4th IC space, left sternal edge
Ejection systolic mumur
Causes of cyanotic heart disease
Right to left shunts
- Transposition of great arteries (always cyanotic)
- Severe VSD and ASD
- PDA
Causes of cyanotic heart disease
Right to left shunts
- Transposition of great arteries (always cyanotic)
- Severe VSD and ASD
- PDA
________ and ______ are compensatory mechanism for the transposition of the great arteries
Patent PDA
VSD/ ASD
- Oxygenated blood to be shunted back into systemic circulation
Management of transposition of the great arteries
Prostaglandin infusion
- Keeps PDA potent
Balloon septostomy
- Catheter in foramen ovale = creates a large ASD
Definite treatment
- Arterial switch
Coarctation of the aorta is associated with _______
Turner syndrome
Presentation of coarctation of aorta
Tachypnoea
Poor feeding/ weight gain
Grey/floppy
- Weak femoral pulses
- Underdeveloped left arm
- Underdeveloped legs
Left ventricular heave
Murmur heard in coarctation of the aorta
Systolic murmur in the left infraclavicular area
Management of coarctation of aorta
Prostaglandins
- PDA open
Surgical correction of coarctation
Aortic stenosis presents with a _______ pulse and _______ pulse pressure
Slow rising pulse
Narrow pulse pressure
Blood findings of a congential cyanotic heart disease
Significant hypoxia
Metabolic acidosis (due to hypoxia)
Investigations for congenital heart disease
Bloods
- VBG: oxygen, acid-base status
ECG
Echo
Chest Xray (heart size)
