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MD 3 - Paeds > cardiology > Flashcards

cardiology Flashcards

1
Q

treatment of ASD

A
  • 80% close spontaneously

- large defects should be closed surgically before school age

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2
Q

typical murmur and heart sounds of an ASD

A
  • ejection systolic murmur, loudest in the left upper sternal border
  • fixed splitting of S2
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3
Q

Which heart defects are associated with Noonan’s syndrome

A

Pulmonary stenosis

pulmonary branch stenosis

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4
Q

Sx of cardiac failure in infants

A
  • feeding difficulties
  • early fatiguability
  • diaphoresis while sleeping/eating
  • respiratory distress
  • lethargy
  • FTT
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5
Q

treatment of a patient with coarctation of the aorta

A
  • medical - prostaglandin E2 in neonates (to reopen the ductus arteriosus)
  • surgery or catheter
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6
Q

which major congenital heart diseases cause high pulmonary blood flow

A

ventricular septal defect
atrial septal defect
patent ductus arteriosus

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7
Q

at what age is the most likely time you will hear a Still’s murmur

A

2-6 years

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8
Q

classic venous hum murmur

A
  • low pitch continuous murmur
  • maximal over the upper sternal edges, but often R>L
  • louder when erect
  • quieter when head turned away or jugular vein compression
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9
Q

which Congenital heart disease is associated with fixed splitting of S2

A

atrial septal defect

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10
Q

the figure 3 sign is suggestive of

A

coarctation of the aorta

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11
Q

4 main types of innocent murmur

A

still’s murmur
pulmonary flow murmur
branch pulmonary stenosis
venous hum

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12
Q

4 key findings on examination of a child in heart failure

A

tachycardia
tachypnoea
cardiomegaly
hepatomegaly

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13
Q

4 components of tetralogy of fallot

A
  • ventricular septal defect
  • pulmonary stenosis
  • over-ride of the aortic valve
  • right ventricular hypertrophy
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14
Q

haemodynamic consequence of TOF

A

right to left shunting

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15
Q

treatment of TGA

A
  • prostaglandins to maintain ductal patency
  • balloon atrial septostomy ASAP
  • arterial switch surgery in first 2 weeks
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16
Q

which congenital heart disease is associated with a delay in P2

A

pulmonary stenosis

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17
Q

which VSD location has the highest rate of spontaneous closure

A

muscular

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18
Q

what are the 3 locations that a VSD can be in

A

perimembranous
muscular
double committed

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19
Q

innocent murmurs always:

A
  • are systolic
  • vary with position
  • vary with respiration
  • have normal heart sounds
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20
Q

what is the Eisenmenger complex

A

pulmonary vascular resistance changes caused by CHD may be irreversible at ~1 year

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21
Q

main DDx you want to exclude when you think you hear a venous hum

A

patent ductus arteriosus

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22
Q

typical heart sounds of a patient with a patent ductus arteriosus

A
  • continuous machinery murmur that obliterates the second heart sound heart best below the left clavicle
23
Q

at what age is the most likely time you will hear a pulmonary flow murmur

A

children-adolescents

24
Q

at what age is the most likely time you will hear a branch pulmonary stenosis murmur

A

infants

25
Q

classic murmur and heart sounds of pulmonary stenosis

A
  • ejection systolic murmur with an ejection click, loudest at the left upper sternal edge
  • radiation to back
  • delay in P2
26
Q

classic branch pulmonary stenosis murmur

A
  • systolic murmur radiating to the axilla and back
27
Q

management includes prostaglandin infusion and balloon atrial septosomy

A

TGA

28
Q

which VSD location has the lowest rate of spontaneous closure

A

double committed

29
Q

haemodynamic consequence of a large VSD

A

volume loading of the left ventricle and increased pulmonary blood flow –> decreased pulmonary compliance –> increased WOB

30
Q

which heart defects are associated with Down syndrome

A

AVSD

VSD

31
Q

classic still’s murmur

A
  • musical hum
  • early to mid systolic
  • crescendo then decrescendo
  • maximal over the LLSE
  • disappears when erect and audible when erect
32
Q

when would you give medical treatment over surgical treatment for a large VSD

A

usually to defer surgery in very small infants until slightly older

33
Q

which heart defects are associated with Turner’s syndrome

A

coarctation of the aorta

34
Q

2 major cyanotic congenital heart diseases

A

tetralogy of fallot

transposition of the great arteries

35
Q

clinical presentation of TGA

A

severe progressive cyanosis developing over first days of life

36
Q

typical clinical presentation of a patient with coarctation of the aorta

A
  • tachypnoea
  • weak or absent femoral pulses
  • radio-femoral delay
  • classic murmur
  • marked discrepancy between BP of arms and legs
37
Q

classical murmur and heart sounds of a ventricular septal defect

A
  • harsh pan-systolic murmur heart best over the left lower sternal border
  • thrill
38
Q

which congenital heart disease has associations with other heart defects

A

coarctation of the aorta

39
Q

typical murmur and heart sounds of a patient with coarctation of the aorta

A
  • continuous murmur heard over the back
40
Q

treatment of pulmonary stenosis

A

first line - catheter

second line - surgery

41
Q

treatment of a PDA

A
  • medical = indomethacin in a premature infant
  • majority will close spontaneously
  • surgery for symptomatic infant
42
Q

classic pulmonary flow murmur

A
  • ejection to mid systolic
  • medium to high pitch
  • maximal over the 2-3rd intercostal in the LUSE
43
Q

treatment of TOF

A

always surgical

44
Q

common location for an atrial septal defect

A

in the region of the fossa ovalis

45
Q

clinical presentation of TOF

A
  • intermittent cyanosis over 6-12 months often not obvious in newborn period
  • hypercapnic spells
46
Q

typical murmur and heart sounds of TOF

A
  • Harsh ejection systolic murmur audible at the left sternal edge radiating to the back
  • second heart sound is often quite loud
47
Q

which heart defects are associated with foetal alcohol syndrome

A

ASD
VSD
TOF

48
Q

typical clinical presentation of a patient with an ASD

A
  • not until the 3rd or 4th decade

- Right heart symptoms

49
Q

typical clinical presentation of a large PDA

A
  • present around 4 weeks
  • weight gain
  • tachypnoea
  • collapsing pulses
  • wide pulse pressure
50
Q

which Congenital heart disease murmurs can be heart on the back

A

coarctation
pulmonary stenosis
TOF

51
Q

which congenital heart disease is the most common

A

ventricular septal defect

52
Q

haemodynamic consequence of an ASD

A

volume loading of the right ventricle and increased pulmonary blood flow –> decreased pulmonary compliance –> increased WOB

53
Q

pulmonary flow murmurs need to be further investigated to rule out which DDx

A

pulmonary stenosis

atrial septal defect

MD 3 - Paeds (18 decks)

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