Cardiology Flashcards
Still’s murmur
age 2-7 MLSB 1-3 systolic vibratory louder supine and w/ exercise
Pulmonic systolic murmur
any age ULSB 1-2 EARLY systolic blowing louder supine and w/ exercise
Venous hum
any age
heard below clavicles
continuous, ONLY while sitting or standing
Primum ASD
Lower septum
cleft in mitral valve may also exist, causing MR
Seen in Down syndrome
Secundum ASD
MCC of ASD
middle part of septum
Sinus Venosus ASD
high in septum near junction w/ SVC
R pulmonary veins may drain into RA
Systolic ejection murmur at ULSB
fixed split S2
Diastolic rumble at LLSB
ASD
Look for RAD, RVH, increased PVM
Holosystolic, high pitched murmur at LLSB
Diastolic rumble at apex
VSD, look for LVH, increased PVMs, and RVH
Continuous murmur at ULSB
PDA
Eject clic with systolic ejection murmur with radiation to URSB and apex
AS
LVH
Eject click with systolic murmur at ULSB
PS
RVH
Post-ductal coarction
presents in adolescence
Delayed and dampened femoral pulses
*Bicuspid or stenotic aortic valve may be present
bruit may be heard near the L scapula
Tx for Coarc in neonate
End-to-end anastamosis-50% recurrence
Balloon angioplasty is TOC in recurrent coarc
When do you tx AS?
CHF, chest pain or syncope, 50-70 mmHg gradient
TOC is Ballon valvuloplasty
Replacement 5-10yrs later
Cyanotic newborn Systolic ejection murmur at RUSB decreased PVM R aortic arch Upturned cardiac apex on CXR
TOF
Cyanotic newborn
No murmur
Single S2
Small heart and narrow mediastinum
Transposition
Cyanotic newborn Single S2, no murmur RAE, LAD, LVH Small heart decreased PVM
Tricuspid atresia w/o VSD
NEED TO KEEP PDA OPEN
Cyanotic newborn Pansystolic murmur at LLSB RAE, LAD, LVH Small heart decreased PVM
Tricuspid atresia w/ VSD
Tx for tricuspid atresia
1) Glenn Shunt= SVC–> R pulm aa
2) Fontan procedure= IVC–> pulm aa
* goal is to redirect systemic venous return into the pulmonary aa
Infant w/ mild de-sat or mild cyanosis
Systolic ejection murmur
Single S2
Diastolic murmur at LLSB
Truncus arteriosus
Cyanotic newborn Ejection murmur along LSB increase PBV Enlarged heart "snowman appearance"
TAPVR
Degree of cyanosis depends on presence of PFO or AD that allows for shunting into the L heart
MCC of pericarditis in children
Viral infection (Coxsackie, echo, adeno, EBV)
Harsh, systolic ejection murmur that is worse with standing and valsalva
HOCM
Tx for HOCM
B-blockers or CCBs Muomectomy anti-arrythmics PRN for ventricular dysrhythmias Dual chamber pacing NO SPORTS
