Cardiology Flashcards
Failed CCHD screen
SpO2 < 90% in R hand or either foot
> 3% discrepancy x 3 between R hand and either foot
Murmur
Vibratory
Venous
Innocent
Murmur
3rd heart sounds disappears when sitting up
Normal
Fixed split 2nd heart sound
ASD
Cause of murmur in ASD
Increase in flow through the PV and sometimes PA branches
Murmur
Blowing/harsh
Holosystolic
LLSB
VSD
Systolic ejection click
Varies with respiration
Pulmonary stensosis
Systolic ejection click
Does NOT vary with respiration
Aortic stenosis
Continuous machine-like murmur
Bounding femoral pulses
PDA
Superior QRS axis
Down syndrome
AV canal defect
Vibratory murmur
Louder in spine
Still’s murmur
Murmur disappears with pressure on the jugular vein
Continuous murmur heard in 1st and 2nd R intercostal spaces that varies in intensity just by changes in neck position
Venous hum
LVH without Left axis deviation
Hypertrophic cardiomyopathy
Left axis deviation without LVH
Tricuspid atresia
AV canal defects
Causes of differential cyanosis
TGA + Aortic obstruction (CoA or iAA) or pulmonary hypertension
3 causes of severe cyanosis in immediate newborn period
TGA
Pulmonary atresia
Ebstein malformation
Main side effects of prostaglandin E1
Fever
Apnea
Cyanotic heart disease without murmur
TGA
Tricuspid atresia
Pulmonary atresia
TAPVR
4 components of Tetralogy of Fallot
Pulmonary stenosis
Overriding aorta
VSD
RVH with right axis deviation on EKG
Boot shaped heart on CXR
Single 2nd heart sound
Decreased pulmonary vascularity
Tetralogy of Fallot
Complications after coarctation repair
Recurrence
Hypertension
Complications of tetralogy repair
Arrhythmia
Syncope
Management for Tet spells
Squatting
Morphine
Phenylephrine
Propranolol
Volume expansion
Inability to hear previous murmur
CHD
Tet spell
Most common congenital heart lesion
Transition of Great arteries
Single 2nd best sound
Increased pulmonary vascularitis
Transposition of great arteries
Genetic condition
Conotruncal defect
VSD
22q11 deletion
Genetic condition
AV canal defect
VSD
Down syndrome
Genetic condition
Aortic root dilation and dissection
Mitral valve prolapse
Marfan syndrome
Genetic condition
Supravalvular aortic stenosis
William syndrome
Genetic condition
Supravalvular pulmonic stenosis
Noonan syndrome
Genetic syndrome
Coarctation of aorta
Turner syndrome
Most common symptomatic arrhythmia in children
Supraventricular tachycardia
Prolonged QT
Treatment
QTc > 460
Propranolol
Most likely cause if Vtach + loss of consciousness
Torsades de pointes
Diagnosis of Rheumatic fever
Recent group A strep infection
2 major criteria
Or
1 major + 2 minor criteria
Major (Jones) criteria for rheumatic fever
Polyarthritis
Carditis
Subcutaneous nodules
Erythema marginatum
Sydenham chorea
Minor (Jones) criteria for rheumatic fever
Arthralgia
Fever
Elevated acute phase reactants
Prolonged PR interval
Most common murmur in rheumatic fever
Mitral valve regurgitation
Tender nodules on pads of fingers/toes
Osler nodes
Non-tender red nodules on palms/soles
Janeway lesions
Best study to diagnose endocarditis
Blood culture
Most common cause is acute bacterial endocarditis in children
Staph aureus
Treatment for staph aureus endocarditis
Vancomycin + beta lactamase resistant antibiotic (nafcillin, oxaxillin, cefazolin)
2-8 weeks
Criteria for antibiotic prophylaxis for endocarditis
Unrepaired cyanotic heart disease
Heart disease surgically correct with hardware and other devices within the previous 6 months
Any residual defect near a prosthetic cardiac device
Prosthetic cardiac valve
Previous infective endocarditis
Cyanotic CHD
Repaired CHD
Cardiac transplant
Timing of antibiotic prophylaxis for endocarditis
PO amoxicillin (50mg/kg or adult 2g)
60 minutes prior to the procedure
Most common cause of myocarditis
Coxsackie group B virus
Most common bacterial cause of pericarditis
Staph aureus
Most important study to order when pericarditis or effusion is suspected
CXR
Harsh crunch-like systolic sound over the precordium
Pneuomediastinum
Harsh crunch like systolic sound over the precordium
Pneumomediastinum
Hamman sign
Anterior filling defect in esophagus on lateral projection
Pulmonary sling
