Cardiology Flashcards
mention Cyanotic CHD
- F4
- Tricuspid Atresia
- TAPVR
- TGA
- Truncus arteriosus
first 3 (TAPVR with obstruction) is associated with Lung Oligemia
what is CHD associated with Down $ (Trisomy 21)
- ECD
- VSD
what is CHD associated with Edward $ (Trisomy 18)
- VSD
- ASD
- PDA
what is CHD associated with Patau $ (Trisomy 13)
- VSD
- Dextrocardia
what is CHD associated with Congenital rubella
PDA
what is CHD associated with Turner $ (45,X0)
- Coarctation of Aorta
- Bicuspid AV
what is CHD associated with Noonan $
PS
what is CHD associated with Allagile $
PS
what is CHD associated with IDM
HOCM
what is CHD associated with William $
Supravalvular AS
what is CHD associated with DiGeorge $
Arch of Aorta anomalies (F4)
what is CHD associated with SLE
Congenital Heart block
what is CHD associated with Marfan syndrome
- MVP
- MR
- AR
- Aortic root dilatation
Enumerate CCC of Eisenmenger $
- Hypoxia & Cyanosis
- CCC of PH++ ( 2ry polycythemia - Cor pulmonale - Thromboembolisms)
- Paradoxical emboli
mention manifestations of Eisenmenger $
- Permanant cyanosis after 10y
- Blue clubbing
- disappearance of murmur
- paradoxical emboli
- signs of PH++
TGA finding on X-ray
egg on a string sign
risk of CHD recurrence
after 1 affected sibling → 2 ~ 6%
after 2 affected siblings → 20 ~ 30 %
Aspirin may cause any CHD except
PDA
PVC is present in all CHD except
F4
enumerate signs of PH++
- RVH
- Visible and palpable pulsations over P2
- Loud S2
- functional PS
Regarding VSD
- Presentation is usually early with loud murmur
- < 10% require surgical closure
M/C site of VSD
perimembranous
first presenting symptom in VSD
pulmonary venous congestion
in VSD, if the murmur was low then it became loud
it indicates closure
in VSD, if the murmur was loud then it became low
it indicates Eisenmenger $
indications of surgical closure of VSD
- Membranous; regardless of size
- Large muscular
- small muscular if causing severe symptoms / ccc
- increasing pulmonary pressure
- if it doesn’t show any sign of closure by 5 years (to prevent eisenmenger)
natural history of VSD
◼ Small: most will closely spontaneously within the first few years of life.
◼ Chest infection and congestive heart failure (CHF). Symptoms of HF may later
resolve due to development of pulmonary hypertension.
◼ Pulmonary hypertension: in children with a large left to right shunt, increased
pulmonary flow and pulmonary hypertension will lead to irreversible damage of the
pulmonary capillary vascular bed (pulmonary vascular disease (PVD)).
◼ Eisenminger syndrome: Advanced pulmonary vascular disease with cyanosis due to
intracardiac right to left shunting, commonly after the first 10years of life.
◼ Acquired pulmonary stenosis
◼ Infective endocarditis
how to differentiate between functional PS murmur in ASD and true PS
- ASD → Wide fixed splitting
- PS → Wide variable
most common location of ASD
ostium secondum ( fossa ovalis)
type of ASD in AVSD
ostium primum
type of growth retardation in PDA
disproportionate
in case of a preterm, PDA closes spontaneously after
3 months
to differentiate between cardiac and pulmonary causes of cyanosis
hyperoxia test
type of VSD in F4
wide membranous (non-functioning)
M/C cyanotic heart disease
F4
M/C type of PS in F4
subvalvular (occur after 6 months)
what is the management of Tet spells
- Squatting position
- Oxygen
- Morphine SC
- IV Propranolol 0.1 mg/kg
- NAHCO3
- phenylephrine
prognosis of F4 depends on
degree of RVOT obstruction & efficacy of surgical intervention
M/C cyanotic heart disease in neonates
TGA
2nd M/C Cyanotic heart disease
TGA
degree of cyanosis in TGA depends on
degree of inter-circular mixing
regarding TGA
incidence of coronary artery insufficiency after the switch operation is low.
