Cardiology Flashcards
Syndrome with coarctation of the aorta
Turner’s Syndrome
Syndrome with pulmonary stenosis
Noonan syndrome
Syndrome with truncus arteriosus
DiGeorge Syndrome
Snowman on CXR
TAPVR
CXR with wall to wall heart and cranial bruit
AVM - vein of Galen
Egg on a string on CXR
Transposition of great arteries
Large first born male
Transposition of great arteries
Most common cyanotic lesion
Tetralogy of Fallot
Boot shaped heart on CXR
Tetralogy of Fallot
Syndromes with Tetralogy of Fallot
DiGeorge Syndrome and Down Syndrome
Syndrome with TAPVR infracardiac
Cat Eye Syndrome
Syndrome with Ebstein’s anomaly
Maternal lithium
ASD
WPW
CXR with wall to wall heart
Ebstein’s anomaly
Most common form of CHD excluding bicuspid aortic valve
VSD
Diastolic rumble
Large VSD
Unrepaired VSD can lead to pulmonary HTN and this syndrome
Eisenmenger’s Syndrome
Heart lesion associated with PDA
Congenital rubella
Continuous machinery murmur
PDA
Syndrome with AV Canal
Down Syndrome
Mid systolic click
Mitral valve prolapse
Fixed split S2
ASD
Syndrome with ASD
Holt Oram
CXR with rib notching or 3 sign
Coarctation of aorta
Opening snap
Bicuspid aortic valve
Murmur radiates to suprasternal notch or carotids
Bicuspid aortic valve
Syndromes with bicuspid aortic valve
Turners Syndrome or Coarctation of Aorta
Syndrome with mitral valve prolapse
Marfan’s Syndrome
ECG with LVH
Aortic stenosis
ECG with RVH in neonate, LVH in child
Coarctation of Aorta
ECG with RVH and RAD
Tetralogy of Fallot
ECG with superior QRS axis, LAD
AV Canal
Only cyanotic lesion in neonate with LAD/LVH
Tricuspid atresia
Tx of sick infant with SVT
D/C cardioversion 0.5-1 J/kg
Drug of choice for SVT
IV Adenosine
Delta wave on EKG
Wolff Parkinson White
Sawtooth pattern on EKG
Atrial flutter. Rate greater than 250 is common in children
Fibrillatory baseline and irregular heart rate
Atrial fibrillation
Dilatation and stretch of atrium
Think atrial flutter
Tx of atrial flutter
D/C cardioversion or slow AV node conduction with digoxin, beta blocker, or calcium channel blocker. Consider Coumadin if gone on for more than 24 hrs because of static blood flow and risk of dislodging clot
Wide QRS tachycardia
Ventricular tachycardia
Drug of choice for ventricular arrhythmias
Amiodarone
Drop attacks
Torsades de Pointes
Normal QT interval
Less than 0.45 sec
AR, long QT, deafness
Jervell Lange Nielsen
AD, long QT, no deafness
Romano Ward
Tx for long QT
Tx to prevent torsades: Beta blocker, pacing, or automatic internal cardiac defibrillator
Tx of torsades
Magnesium sulfate, pacing, then shock
Prolonged PR interval >200 msec
First degree heart block
Changing PR intervals with some P waves are not conducted (dropped QRS)
Second degree heart block. Mobitz type 1. Wenckebach
Equal PR intervals, some p waves are not conducted
2nd degree heart block, Mobitz type 2
No apparent relationship between p waves and QRS
Third degree heart block
Anti Ro and Anti La antibodies
Lupus. Causes congenital heart block from trans placental passage of maternal antibodies (IgG) directed against fetal conduction tissue
Tx for heart block
Pacemaker
Heart defect seen in trisomy 21
AV canal, VSD
Heart defect seen in XO
Coarctation of aorta
Heart defect seen in trisomy 13 and 18
VSD
Heart defect seen in 5p-
VSD
Heart defect seen in 22q11-
Truncus arteriosus, interrupted aortic arch, pulmonary atresia with VSD, tetralogy of Fallot.
Order FISH test for eval.
Heart defect seen in Noonan
Pulmonic stenosis, hypertrophic cardiomyopathy
Heart defect seen in Marfans
Aortic root dilatation/dissection
Heart defect seen in Williams syndrome
Peripheral pulmonic stenosis, supravalvar aortic stenosis
Heart defect seen in Holt Oram Syndrome
ASD, VSD
Heart defect seen in Pompe’s disease
Cardiomyopathy
Heart defect seen in lithium ingestion
Ebstein’s anomaly of TV
Heart defect seen in ethanol ingestion
ASD, VSD
Heart defect seen in anticonvulsant ingestion
PS, AS, TOF
Heart defect seen in retinoic acid ingestion
Transposition
Heart defect seen in rubella
PDA, PPS
Heart defect seen in coxsackie B
Myocarditis
Heart defect seen in maternal diabetes
Hypertrophic cardiomyopathy, TGV
Heart defect seen in lupus
Congenital heart block
Heart defect seen in PKU
VSD, ASD, complex CHD
Shunts reveal themselves at
4 to 6 weeks of age
Chronic increase in pulmonary blood flow causes irreversible pulmonary HTN
Eisenmenger Syndrome
SOB, cyanosis, hemoptysis
Eisenmenger syndrome
Single second heart sound
Pulmonary HTN
Bounding pulses
PDA
Continuous machinery murmur
PDA
Closes PDA
Indomethacin
Fixed split S2
ASD
Most common type of ASD
Ostium Secundum
EKG with left axis deviation
AV canal defect or Tricuspid Atresia
If oxygen sat increases with 100% O2
Lung disease
If oxygen sat does not change with 100% O2
Cardiac disease
Name the 5 cyanotic heart diseases
Tetralogy of Fallot Transposition of Great Arteries Tricuspid Atresia (and/or pulmonary atresia) Truncus Arteriosus Total Anomalous Pulmonary Venous Return
Clubbing of fingers and squatting older child
Tetralogy of Fallot
Boot shaped heart on CXR
TOF
EKG with RVH and RAD
TOF
Tx for tet spell
O2, knee chest position, bicarb, morphine, neosynephrine
Egg shaped heart on CXR
TGA. Often no murmur
Small heart, pulmonary edema, intense cyanosis
Obstructed TAPVR (return goes below the diaphragm)
Heart failure in first week of life
Obstruction to left heart flow
CHF at 6 to 8 years of age
Myocarditis, rheumatic heart fever
Thrill in suprasternal notch region
Aortic stenosis
Who gets rheumatic fever following strep pharyngitis
3% of those affected
Aschoff body on pathology
Acute rheumatic fever
Major Jones criteria
Joints (poly arthritis) Carditis Nodules (subcutaneous) Erythema marginatum Syndeham chorea
Aschoff body on pathology
Acute rheumatic fever
Tx of acute rheumatic fever
ASA 80-100 mg/kg +/- prednisone, digoxin
Tx of chorea
Haloperidol, benzodiazepine
Prevention of acute rheumatic fever
Monthly PCN G IM
Lesions high risk for endocarditis
TOF, VSD, AS
Two organisms that cause most endocarditis cases
Staph aureus and strep viridans
Fever, new murmur, CHF, petechia, Roth spots, Janeway lesions, Soler nodes, splinter hemorrhages
Endocarditis
Prosthetic cardiac valve, h/o endocarditis, unrepaired CYANOTIC CHD or completely repaired with prosthetic material if within 6 months of procedure, cardiac transplant recipients
SBE ppx for dental procedures
Which procedures get SBE ppx?
Procedures on respiratory tract or infected skin
5 days of fever plus 4 other features
Kawasakis
Cervical LAD, conjunctival injection, rash, hand and foot erythema, mucosal involvement
Kawasaki
Tx of Kawasaki
IVIG
High dose aspirin until fever and ESR decrease and platelets increase then low dose ASA
Causes of viral myocarditis
Coxsackie B, echovirus
JVD increasing with inspiration
Kussmaul (seen in pericarditis)
Chest pain, pericardial friction rub, pulsus paradoxus, kussmaul
Pericarditis
HOCM, anomalous left coronary artery, commotio cordis, aortic rupture in Marfans
Causes of sudden cardiac death in athletes
Heart defect in maternal diabetes
Septal hypertrophy
Bounding pulses
PDA, aortic insufficiency