Cardiology Flashcards
What are clinical features of ventricular septal defects?
Asymptomatic
Heart failure - tachypnoea, tachycardia, enlarged liver
Recurrent chest infection
Pansystolic murmur
What are investigations for VSD?
CXR
ECG
ECHO
What is medical management of VSD?
Diuretics - e.g. furosemide and spironolactone
ACE inhibitor - e.g. captopril
Additional calorie input – e.g. high calorie formula, NG tube
Spontaneous closure of VSD
What is surgical management of VSD?
VSD closure (3-6mths)
Required if medical management not controlling symptoms
What are clinical features of atrial septal defects?
Asymptomatic, chest infections, wheeze
Ejection systolic murmur
What are investigations for ASD?
ECG
ECHO
CXR
What is management of ASD?
Cardiac catheterisation or surgical correction to close the defect and prevent right heart failure
What are future complications of ASD?
Arrhythmias
Stroke
What is ductus arteriosus?
Ductus arteriosus connects the pulmonary artery to the descending aorta - usually closes shortly after birth
What is patent ductus arteriosus?
Failure of ductus arteriosus to close 1 month after birth - left to right shunt from aorta to pulmonary artery
What are clinical features of PDA?
Continuous (machinery) murmur beneath the left clavicle
Heat failure – faultering growth and LRTI
What is the investigation for PDA?
ECHO
What is the management of PDA?
Coil or occlusion device via cardiac catheterisation
Preterm infants – Indomethacin (NSAID)
What are options for management of aortic stenosis?
Balloon aortic valvuloplasty
Surgical repair
Valve replacement
What is coarctation of the aorta?
Narrowing of aortic arch - high blood pressure in upper body and low blood pressure in lower body (low volume femoral pulse)
Left ventricular hypertrophy
What are clinical features of coarctation of the aorta?
Examination on first day of life is usually normal
Severe heart failure – enlarged liver
Absent femoral pulses
Severe metabolic acidosis
What are investigations of coarctation of the aorta?
CXR - cardiomegaly from HF and shock
ECG - normal
What is the management of coarctation of the aorta?
ABC resuscitation
Prostaglandin infusion - Dinoprostone
Surgical repair or stent insertion
What is atrioventricular septal defect?
Abnormality of the inlet valves - one conjoint inlet valve instead of separate mitral and tricuspid valve
Complete AVSD has interatrial and interventricular defects
What is tetralogy of fallot?
VSD
Overriding aorta
Pulmonary stenosis
Right ventricular hypertrophy
What is the presentation of tetralogy of fallot?
Antenatally
Pulmonary stenosis - ejection systolic murmur
VSD - pansystolic murmur
What are clinical features of tetralogy of fallot?
Hypercyanotic spells - turning blue
Clubbing in older children
What is tetralogy surgical repair?
Pulmonary artery patch
VSD patch
How are congenital heart defects screened?
Antenatal scans
Newborn check
6 week check - auscultation, femoral pulse, respiration, weight gain, colour
