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Paediatrics > Cardiology > Flashcards

Cardiology Flashcards

0
Q

What is a sign of heart failure in children? (You wouldn’t normally test in a adult)

A

Hepatomegally

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1
Q

When describing murmurs which 5 things do you describe?

A 
Timing - systolic/diastolic/continuous
Duration - ejection or pan
Loudness - grade 1-6
Site of maximal intensity 
Radiation
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2
Q

What is the likely cause of a collapsing pulse in a child?

A

PDA

Aortic regurg

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3
Q

What is the purpose of the firemen ovale?

A

In the fetus blood return from the lung is limited but return to the RA from body and placenta is increased.
It allows the blood to shunt R to L to spread the pressure

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4
Q

What two structures does the ductus arteriosus connect?

A

Pulmonary artery and aorta

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5
Q

What are the two types in innocent murmurs?

A

Ejection murmur

Venous hum

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6
Q

What causes a venous hum?

A

Turbulent flow in head and neck veins

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7
Q

Where is the venous hum heard best?

What can make it louder?

A

Beneath each clavicle

Inspiration
Exercise

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8
Q

What can make a venous hum quiter?

A

Lying flat

Occluding the jugular vein on ipsilateral (same) side

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9
Q

Does the vascular resistance in the lungs increase or decrease after birth?

A

Decrease to allow more blood to flow into lungs and therefore increase blood flow to LA

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10
Q

When would you want to maintain a PDA?

A

In a duct dependant pulmonary circulation ie blood flows from aorta into pulmonary artery to lungs as pulmonary artery isn’t attached to RV

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11
Q

What is the usual cause of heart failure in neonates?

A

Left hear obstruction eg coarctation of the aorta

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12
Q

What percentage of VSD requires closure?

A

10%

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13
Q

What are the 4 components of tetralogy of Fallots?

A

Large VSD
Overriding aorta
Pulmonary infundibular stenosis
Right ventricular hypertrophy

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14
Q

In tetralogy of Fallots what might the X-ray show?

A

Boot shaped heart

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15
Q

At what age is surgical correction carried out?

A

2/3 months

16
Q

Does tetralogy of Fallots lead to cyanotic heart disease or heart failure?

A

Cyanotic

17
Q

In tetralogy of Fallots is there a L to R R to L shunt

A

R to L as the deoxygenated blood moves from the right to left to cause cyanosis

18
Q

What are the 4 defects in Fallots tetralogy?

A

Pulmonary stenosis (R outflow obstruction)
Large VSD
Overriding aorta
R ventricular hypertrophy

(1st 2 are more important)

19
Q

What is the incidence of congenital heart disease?

A

7-8/1000 live births

20
Q

What does the transposition of the great arteries look like on X-ray?

A

Egg on a string on its side

21
Q

What is the immediate management of transposition of great arteries?

A

Prostaglandin E1

Balloon atrial septostomy

22
Q

What would the murmur sound like in 1) Fallots or 2) transposition

A

1) loud ejection systolic

2) no murmur usually

23
Q

What murmur does atrial septal defect present with?

Were is this best heard?

A

Fixed split S2 (no variation with resp)

Ejection systolic murmur

Also mid diastolic

(More blood going to R side of heart making blood flow more noisy at tricuspid and pulmonary valve)

Second intercostal L sternal edge

24
Q

Does ASD lead to L to R or R to L shunt?

A

L TO R

25
Q

What symptoms for you get with ASD?

A

Mainly assymptomatic, picked up as murmur

26
Q

In VSD where is the murmur best heard?
What type of murmur is it?
Where does it radiate?

A

Left lower sternal edge

Harsh pan systolic

All over the chest

27
Q

What are the signs of heart failure in neonates?

A 
failure to thrive 
Tachycardia 
Tachypnoea
Crepitations 
Hepatomegaly
28
Q

If VSD remains uncorrected either by not closing naturally or not getting surgery what happens to the shunt?
Clinically what is seen?

A

It reverses from R to L sure to pulmonary hypertension the R can’t push the blood through Pulmonary artery so goes backwards through the shunt.
Intractable cyanosis

29
Q

What are the 3 categories that cause heart failure in children?

A

Obstructive causes
Left to right shunt
Cardiomyopathy

30
Q

What is a complication of VSD?

A 
Infective endocarditis 
(No longer give antibiotic prophylaxis though)
31
Q

Describe a murmur with persistent PDA?

A

In younger children systolic murmur at L sternal edge

In older continuous murmur under left clavicle (is continuous as pressure is alway higher in the aorta)

32
Q

What is the triad of symptoms in aortic valve stenosis

A

Chest pain (less so in children)
SOB
Syncope

33
Q

What condition is associated with AVSD? W

A

Down’s syndrome

34
Q

Describe a a murmur associated with pulmonary valve stenosis

A

Ejection systolic radiating to back loudest over upper L sternal edge

35
Q

There are two types of ASD secundum and ostium, what is the difference in a Anatomy?

A

Secundum - defect in foramen ovale and surrounding atrial septum
Primium - defect of atrioventricular septum

Paediatrics (12 decks)

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