Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

3a Child Health > cardiology > Flashcards

cardiology Flashcards

1
Q

What is a ventricular septal defect

A

A congenital hole anywhere in the ventricular septum causing a left to right shunt

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Explain how VSDs can cause pulmonary HTN and HF

A
  • A left to right shunt leads to right sided overload, right HF and increased flow into the pulmonary vessels
  • extra blood flowing through the right ventricle increases the pressure in the pulmonary vessels over time, causing pulmonary HTN
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Give one genetic condition commonly associated with VSDs

A

Down’s syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

VSDs can be considered small or large. Which is more common

A

Small VSDs (80-90%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the key distinguishing factor between small and large VSDs in terms of size

A

Small VSDs are smaller than the aortic valve (<3mm) whereas large VSDs are the same size or bigger than the aortic valve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

2 clinical features of a small VSD

A
  • Typically asymptomatic
  • Loud pansystolic murmur at the left lower sternal border
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Give 3 clinical features of a large VSD

A
  • Dyspnoea/ tachypnoea
  • Failure to thrive
  • Soft pansystolic murmur/ no murmur
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

In VSDs, where can the murmur be heard best

A

Left lower sternal border in the third and fourth intercostal spaces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How are VSDs investigated

A
  • GS: ECHO - show precise anatomy of defect
  • CXR - may show cardiomegaly and enlarged pulmonary arteries if large defect
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How are small VSDs managed

A
  • Should be monitored as they often close spontaneously
  • Maintain good dental hygiene to prevent bacterial endocarditis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

3 complications of VSDs

A
  • Einsenmenger syndrome
  • Endocarditis
  • Heart failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How are large VSDs managed

A
  • reduce risk of IE: Abx prophylaxis
  • surgical correction: open heart or transvenous catheter closure
  • HF: Diuretics +/- captopril
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is Eisenmenger’s syndrome

A

the reversal of a left-to-right shunt in a congenital heart defect due to pulmonary hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What causes Eisenmenger’s syndrome

A

occurs when an uncorrected left-to-right shunt leads to remodelling of the pulmonary microvasculature, eventually causing obstruction to pulmonary blood and pulmonary hypertension.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Features of Eisenmenger’s syndrome

A
  • original murmur may disappear
  • cyanosis
  • clubbing
  • right ventricular failure
  • haemoptysis, embolism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is an atrial septal defect

A

Congential hole in the septum between the atria that causes a left to right shunt

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Give 3 RFs of atrial septal defects

A
  • maternal smoking in 1st trimester
  • maternal diabetes
  • maternal rubella
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Give 2 types of atrial septal defects

A
  • Secundum ASD- mc
  • Partial atrioventricular septal defect (primum ASD)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Give symptoms of atrial septal defects in both child and adult

A
  • Child: typically asymptomatic, recurrent chest infections
  • Adult: present with dyspnoea and arrhythmias
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Give 2 cardiac signs of atrial septal defects

A
  • Ejection systolic murmur, louder on inspiration, heard at the upper sternal border
  • Fixed and widely split second heart sound
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How are atrial septal defects investigated

A
  • ECHO - diagnostic
    ECG:
  • secundum: partial RBBB, R axis deviation
  • partial AVSD: RBBB, left axis deviation, prolonged PR
  • CXR - cardiomegaly
22
Q

How are atrial septal defects managed

A
  • <1mm - manage conservatively, spontaneous closure
  • Secundum ASD - transvenous catheter closure
  • primum - surgical correction
23
Q

Give 4 complications of atrial septal defects

A
  • stroke due to VTE
  • Atrial fibrillation or atrial flutter
  • Pulmonary HTN and right HF
  • Eisenmenger syndrome
24
Q

Explain why atrial septal defects can cause a stroke in patients with a DVT

A
  • Clot from DVT can travel from the right atrium to the left across the ASD
  • Clot can travel to the aorta and up to the brain causing a large stroke
25
Q

What is patent ductus arteriosus

A
  • Persistent connection between the aorta and pulmonary artery causing a left to right shunt
  • Failure of the ductus arteriosus to close one month after exp delivery date
26
Q

How is a patent ductus arteriosus diagnosed

A

ECHO
* size and characteristics of shunt
* LVH/ RVH

27
Q

Give 5 clinical features of a patent ductus arteriosus

A
  • left subclavicular thrill
  • continuous machinery murmur at upper left sternal edge
  • large volume, bounding, collapsing pulse
  • heaving apex beat
  • wide pulse pressure
28
Q

How is a patent ductus arteriosus managed

A
  • asymptomatic: observe for spontaneous closure
  • Indomethacin or Ibuprofen inhibits prostaglandin and stimulates duct closure
  • Closure via cardiac catheterisation around 1 year old (sooner if more severe)
29
Q

Give 2 RFs of a patent ductus arteriosus

A
  • Maternal rubella
  • Prematurity
30
Q

What are the 4 cardinal anatomical features of Tetralogy of Fallot

A
  • Ventricular septal defect
  • Overriding aorta
  • Pulmonary valve stenosis
  • Right ventricular hypertrophy
31
Q

What kind of shunt is caused by Tetralogy of Fallot

A

Right to left

32
Q

Give 3 RFs for Tetralogy of Fallot

A
  • Rubella
  • Maternal age (>40)
  • Alcohol consumption during pregnancy
33
Q

5 clinical features of Tetralogy of Fallot

A
  • Cyanosis
  • HF before age 1 in severe cases
  • Harsh ejection systolic murmur due to pulmonary stenosis
  • Clubbing in older kids
  • Hypercyanotic (tet) spells that may result in loss of consciousness
34
Q

Describe tet spells

A
  • rapid increase in cyanosis due to near occlusion of the right ventricular outflow tract
  • features: tachpnoea, severe cyanosis, may result in LOC
  • Kids may squat or put their knees to their chest
  • typically occurs when infant is upset, in pain or has a fever
35
Q

What determines the degree of cyanosis and clinical severity in tetralogy of fallot

A

The severity of the right ventricular outflow tract obstruction due to pulmonary stenosis

36
Q

Investigations for Tetralogy of Fallot

A
  • GS: ECHO - demonstrate cardinal features
  • CXR - boot shaped heart
  • ECG - RVH
37
Q

How is Tetralogy of Fallot managed

A
  • Definitive surgical repair around 6 months - open heart
  • Neonates with profound cyanosis: prostaglandin (alprostadil) infusion to maintain patent ductus arteriosus
38
Q

When and how are tet spells managed

A
  • when lasting over 15 mins
  • manoeuvres to increase systemic venous return
  • Sedation and IV morphine - calm the child
  • IV propanolol
  • IV fluids
  • Na bicarbonate - reverse acidosis
  • Supplementary O2
39
Q

What is transposition of the great arteries

A

When the aorta is connected to the right ventricle and the pulmonary artery is connected to the left ventricle

40
Q

Why is transposition of the great arteries life threatening after birth

A
  • There is no connection between the systemic and pulmonary circulation
  • The baby will be cyanosed
41
Q

Survival of a baby with transposition of the great arteries depends on what?

A

Presence of a naturally occurring associated anomaly
* i.e. left to right shunt - AVD, VSD, PDA which will allow blood to mix

42
Q

Clinical features of transposition of the great arteries

A
  • Cyanosis
  • loud single S2
  • prominent right ventricular impulse is palpable on exam
  • tachycardia, tachypnoea
  • Delayed presentation if there is an associated anomaly that allows mixing
43
Q

Investigations for transposition of the great arteries

A
  • ECHO
  • CXR - narrow mediastinum and cardiomegaly (egg on string)
44
Q

How is transposition of the great arteries managed

A
  • Prostaglandin infusion - Maintain patency of ductus arteriosus to improve mixing
  • Balloon atrial septostomy
  • Open heart surgery within the first few days of life
45
Q

What is coarctation of the aorta

A

congenital narrowing of the descending aorta

46
Q

Give 4 conditions associated with coarctation of the aorta

A
  • Turner’s syndrome
  • bicuspid aortic valve
  • berry aneurysms
  • neurofibromatosis
47
Q

Is coarctation of the aorta more common in males or females

A

males

48
Q

Describe the presentation of coarctation of the aorta

A
  • infancy: heart failure - acute circulatory collapse at 2 days of age when the duct closes
  • adult: hypertension, Notching of the inferior border of the ribs
49
Q

Findings indicative or coarctation of the aorta on examination

A
  • radio-femoral delay (weakened femoral pulse)
  • mid ejection systolic murmur, heard under left clavicle and over the back
  • apical click from the aortic valve
50
Q

How is coarctation of the aorta managed

A
  • immediate administration of IV prostaglandins to allow adequate circulation
  • definitive - corrective surgery

3a Child Health (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions