Cardiology Flashcards
- decreased perfusion/pulses in LE
- Sx of CHF, shock, acidosis, lethargic
- Tx: Prostin
Coarctation of the Aorta
- difficulty feeding, FTT, tachypnea, tachycardia
- Tx: diuretics
CHF
- TGA
- TOF
- TA
- TAPVR
Cyanotic heart disease
- iron in the Hb molecule is defective making it unable to effectively carry O2 to the tissues
- congenital or acquired
- cyanosis
- child having formula mixed with well water
- acidosis, tachycardia, and shock (no resp distress)
- Tx: methylene blue
Methemoglobinemia
- none of the 4 veins that drain blood from the lungs to the heart are attached to the LA
- oxygenated blood drains into the RA instead
- incompatible with life w/o PDA, PFO
- veins may pass through the diaphragm causing obstruction
- FT infant with incr RVV activity, cyanosis & pulm edema, single S2, short systolic murmur
- Xray: normal sized heart + pulm congestion
TAPVR
- good APGARs at birth
- cyanosis on day 2
- tachypnea and decr pulm markings on CXR
- Tx: Prostin
Ductal dependent lesions
- pulmonary stenosis
- overriding Ao arch
- VSD
- RVH
- palpable RV impulse, single S2
- EKG: RVH
- CXR: boot shaped heart
- MC heart condition OVERALL
TOF
- hypercyanotic hypoxic episodes
- Triggers: anemia
- results from incr R to L shunting
- Tx: push knees to chest (incr PVR), morphine, phenylephrine, propranolol, volume expansion
Tet spell
- underdevelopment of the LV, Ao, and Ao valve
- severe CHF, marked cardiomegaly, precordial hyperactivity, loud S2
- no murmur (pulm and Ao pressures are equal)
- Tx: prostin
HPLHS
- Ao connected to the RV and the RA to the LV
- MC CHD presenting with cyanosis in the first week of life
- blood must mix either through PFO ro PDA (ductal dependent)
- tachypnea, SINGLE S2
- CXR: egg shaped heart, incr pulm vascularity
- Tx: prostin, balloon septostomy
TGA
- generalized facial swelling, fatigue, wt loss, night sweats, dusky color from venous stasis
- normal sats
SVC syndrome
- newborn in resp distress shortly after delivery
- SpO2 LE<UE
- incr workload RV, precordial lift
- PVR>SVR
- R to L shunt
- common with pulm disease
Persistent Fetal Circulation
- 1-2 week h/o lethargy, low grade fever
- splenomegaly, petichiae, tender lesions on pads of fingers and toes, systolic ejection click at apex, diastolic murmur on the right
- confirm with blood culture
- MC S. aureus in ABE
- MC Strep viridans in SABE
Endocarditis
- recent URI leading to tachycardia
- enlarged liver, gallop
- MC causeL cocksackie B
- pulsus paradoxus, EKG low voltage, abnl T waves, ST depression
- Dx: viral serology
- steroids are controversial
myocarditis
- inflammation of pericardial sack involving epi and pericardium
- causesL viral or collagen vascular disease
- may be accompanies by effusion
- muffled heart sounds, pericardial friction rub, low grade fever, JVD
- L sided chest pain worse supine
- CXR: cardiomegaly**
- echo: pericardial fluid
- Tx: pericardiocentesis
Pericarditis
-vibratory, venous hums, carotid bruits
Innocent Murmurs
-Murmur +
exercise intolerance, dyspnea, cyanosis, syncope, wheezing
Pathologic Murmur
- best heard at LLSB
- pansystolic
- loud single S2
- hyperdynamic precordium
VSD
-maternal med associated with Epstein anomaly
Lithium
-maternal drug associated with VSD/ASD
EtOH
- bounding carotid pulse
- decr peripheral pulses
- AVM
Cranial Bruits
-pansystolic murmur (2 types)
PDA or venous hum
EKG: LVH
-Name associated CHD
Aortic stenosis
-CHD associated with R axis deviation on EKG from RVH
TOF
-CHD associated with superior QRS axis (30-90 degrees) & L axis deviation
AV canal defect
- generally benign arrhythmia
- exceptions are children on Digoxin and children <1yo (risk for a flutter)
PACs
-shortened PR interval and/or a delta wave
WPW
