Cardiology Flashcards
How is pulmonary stenosis murmur usually characterised?
Ejection systolic murmur heard loudest at ULSE
Click after first heart sound
What heart issues are usually associated with Noonan’s syndrome?
Pulmonary stenosis and hypertrophic cardiomyopathy
What could small voltages in all ecg leads indicate?
Pericardial effusion
Myxoedema
What cardiac condition is associated with William’s syndrome?
Supravalvular aortic stenosis
What is the most common CHD associated with Down’s syndrome?
AVSD
What cardiac condition is seen in those with Turner syndrome?
CoA and bicuspid aortic valve
What cardiac defect is found in 90% of children with Alagille syndrome?
Peripheral pulmonary artery stenosis
What is the typical murmur associated with coarctation of the aorta?
Ejection systolic murmur at ULSE that radiates to the back
What is the mechanism of development of tetralogy of Fallot?
Displacement of the outflow tract septum which reduced calibre of pulmonary artery and enlarges the aorta
How is hypertrophic cardiomyopathy usually inherited?
AD fashion
Which gene is associated with prolonged QT syndrome?
KCNQ1 gene
What are the 4 features of tetralogy of Fallot?
Pulmonary stenosis
Over-riding aorta
VSD
RV Hypertrophy
Which mutation in hypertrophic cardiomyopathy is most associated with sudden death and mild hypertrophy?
Troponin T mutations
What type of mutation is the most common cause of hypertrophic cardiomyopathy?
Mutations on the beta-cardiac myosin heavy chain
What are the differentials for a baby with collapse at 2 days of age and no cyanosis?
Obstructed left heart
- Coarctation
- HPLHS
- Critical AS
Sepsis
Give examples of causes of QT-prolongation?
Hypothermia
Hypocalcaemia
Hypokalaemia
Hypomagnesaemia
Head injury
Domperidone
Erythromycin
What are the typical ecg appearances in severe LV cardiomyopathy?
Inverted T-waves especially in lateral leads e.g. V6
What would an ECG show in tetralogy of Fallot?
Signs of RVH with an upright T wave in V1, R axis deviation, dominant S wave in V5 and V6
In WPW syndrome, what is the accessory pathway called?
Bundle of Kent
What occurs in Phase 4 of the cardiac action potential cycle?
Diastole
Sodium-calcium efflux and potassium influx
In WPW syndrome, what is happening within the heart that causes the delta wave to show on the ecg?
Early depolarisation of cells in accessory pathway during the refractory period between AVN and bundle of His.
What does the murmur in ASD sound like?
Systolic murmur over pulmonary area (ULSE) typically associated with wide, fixed split S2.
Which virus can cause dilated cardiomyopathy?
Enterovirus
What is Lown-Ganong-Levine syndrome?
Rare condition which is a pre-excitation syndrome.
Presents with a short PR interval, palpitations and no delta wave.
AVN fails to act as a “gatekeeper” meaning signals pass rapidly through.
What CHD can right sided aortic arch sometimes be associated with?
Tetralogy of Fallot
Which cardiac condition is associated with DiGeorge syndrome?
Tetralogy of Fallot
What occurs in Phase 2 of the cardiac action potential cycle?
Plateau phase
Slow influx of calcium
What occurs in Phase 1 of the cardiac action potential cycle?
End of depolarisation
Efflux of potassium
What is the main cardiac defect in Holt-Oram syndrome?
ASD
What occurs in Phase 0 of the cardiac action potential cycle?
Depolarisation
Rapid sodium influx
What occurs in Phase 0 of the cardiac action potential cycle?
Rapid repolarisation
Efflux of potassium
What are the ECG changes of viral myocarditis?
ST segment changes and T-wave inversion most common
Can also show elevated QRS amplitude and prolonged QRS and QT
What is the initial adenosine dosage for SVT?
0.1mg/kg
What conditions are associated with pulmonary hypertension?
CLD
Large VSD
PDA
AVSD
Cardiomyopathy
ToGA
What condition can cause prolonged QT interval along with congenital sensorineural deafness?
Jervell-Lange-Nielsen syndrome
What is the initial bolus dose of adenosine for a child <1year with SVT unresponsive to vagal manouvres?
150mcg/kg
What cardiac defects are associated with rubella infection?
PDA with branch pulmonary artery stenosis
What happens to flow across ductus arteriosus a few minutes following birth?
Reversal of flow from R>L to L>R - also closure of foramen ovale
