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Pediatrics > Cardiology > Flashcards

Cardiology Flashcards

1
Q

What is the most common cause of CHF in kids

A

Ventral Septal Defect

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2
Q

In a VSD (ventral septal defect) what does the size of the defect tell you about the murmur

A

Small Hole: Loud Murmur

Large Hole: Quiet Murmur

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3
Q

In a small hole in VSD, what shunt results

A

Left to Right Shunt

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4
Q

In a large hole in VSD, what happens with stroke volume

A

Increased SV across Pulmonary Outflow Tract

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5
Q

What type of murmur is heard in VSD

A

Systolic crescendo-decrescendo murmur (especially in large VSD)

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6
Q

Sx of VSD

A

Poor Weight Gain, Small size for age, Dyspnea on feeding, Frequent URI
Prominent RV impulse, palpable pulmonary artery pulsation

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7
Q

What do you see in CXR in VSD

A

Cardiomegaly and increased pulmonary vascular markings

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8
Q

What do you see on EKG in VSD

A

Large QRS in leads I and II

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9
Q

Tx for VSD

A

Most resolve spontaneously

With a large VSD + HF: Diuretics, Digoxin, and Ace-I before surgery

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10
Q

When do sx start with ASD (Atrial Septal Defect)

A

Adulthood

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11
Q

If sx do start in childhood what do you see with ASD

A

Recurrent URI, Failure to thrive, exertional dyspnea, atrial arrhythmias, syncope

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12
Q

What murmur do you hear with ASD

A

Systolic crescendo-decrescendo at pulmonic area

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13
Q

What do you see in CXR with ASD

A

Cardiomegaly

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14
Q

What do you see on EKG in ASD

A

RBBB, RVH, RAE

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15
Q

Tx for ASD

A

Spontaneous Closure

Surgery

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16
Q

What is the Ductus Arteriosus

A

Fetal circulation component that links pulmonary artery with descending aorta
Closes a couple hours/days after delivery

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17
Q

Sx with Patent Ductus Arteriosus

A

Poor Feeding, Weight loss, frequent URI, pulmonary congestion, pulmonary HTN

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18
Q

What results with a Patent Ductus Arteriosus

A

Right to Left Shunt

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19
Q

What kind of murmur is heard with Patent Ductus Arteriosus

A

Machine-Like Murmur, Continuous at 2nd intercostal space through systole and diastole

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20
Q

What do you see on EKG with Patent Ductus Arteriosus

A

LVH and LAE

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21
Q

Tx for Patent Ductus Arteriosus

A

Prostaglandin Inhibitor: Indomethacin

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22
Q

What is Coarctation of the Aorta

A

Congenital narrowing of descending aorta

23
Q

What is commonly seen along with Coarctation of the Aorta

A

Bicuspid Aortic Valve

24
Q

Sx of Coarctation of the Aorta

A

Higher BP in upper extremeties compared to lower extremities
Dealyed/Weak femoral pulses
Shock, failure to thrive, secondary HTN
Bilateral Claudication

25
Q

What murmur is heard with Coarctation of Aorta

A

Systolic murmur that radiates to back/scapula/chest

26
Q

Dx of Coarctation of Aorta

A

Angiogram is gold standard
CXR: Rib notching
EKG: LVH

27
Q

Tx of Coarctation of Aorta

A

Baloon Angioplasty

Prostalgandins

28
Q

What are the 4 main characteristics of Tetralogy of Fallot

A
  1. Right outflow obstruction
  2. RVH
  3. Overriding aorta: Portion of aorta lined up over septum
  4. Large VSD
29
Q

What results with Tetralogy of Fallot

A

Right to Left Shunt

30
Q

Sx of Tetralogy of Fallot

A

Blue Baby Syndrome

Tet-Spells: Older kids with cyanosis squat to relieve sx

31
Q

What kind of murmur is heard with Tetralogy of Fallot

A

Harsh holosystolic murmur at left sternal border

32
Q

Tx of Tetralogy of Fallot

A

Surgery: Blalock-Taussig Shunt

Prostaglandins to keep ductus arteriosus open

33
Q

What is Kawasaki Disease

A

A vasculitis

34
Q

What ethnic group is Kawasaki Disease found in most

A

Asians

35
Q

What is the Dx criteria for Kawasaki Disease

A 
Warm CREAM (Fever + 4)
Conjunctivitis: Bilateral, non-exudative
Rash: Polymorphous
Extremity Changes: Erythema and Edema
Adenopathy: Cervical
Mucous Membranes: Strawberry tongue, cracked lips and oral cavity
36
Q

What are complications from Kawasaki Disease

A

MI, Coronary Arterities, Aneurysms, Myocarditis, Pericarditis, Valvular heart disease

37
Q

Tx for Kawasaki Disease

A

IVIG + High Dose ASA

38
Q

What is Acute Rheumatic Fever

A

When Group A Strep (Strep Throat) is not treated and complicates. It’s an autoimmune reaction to Group A Strep

39
Q

Diagnostic criteria for Acute Rheumatic Fever

A

Recent Strep + 2 Major OR

Recent Strep + 1 Major and 2 Minor

40
Q

What is the Major and Minor Criteria for Acute Rheumatic Fever

A 
Major JONES
J: Joints, Migratory Polyarthritis
O: Active Carditis
N: Subcutaneous Nodules
E: Erythema Marginatum
S: Sydenham's Chorea (movement disorder)

Minor: Fever, Elevated CRP/ESR, Arthralgia, Prolonged PR Interval

41
Q

Tx for Acute Rheumatic Fever

A

Penicillin for Strep (need to give prophylactic until age 18yrs)
ASA and NSAIDS, Corticosteroids for severe cases
Consider valve replacement

42
Q

What is the leading cause of sudden cardiac death in young people

A

Hypertrophic Cardiomyopathy

43
Q

Sx with Hypertrophic Cardiomyopathy

A

Asymptomatic

Anginga, Syncope, Palpitations, Exercise Intolerance, Left precordial bulge

44
Q

Dx of Hypertrophic Cardiomyopathy

A

Echo: Asymmetrical Septal Hypertrophy
Diastolic function is always abnormal
Stress Test: Evaluates LV outflow obstruction
Cath: Ballerina slipper configuration of LV

45
Q

Tx of Hypertrophic Cardiomyopathy

A

Restrict atheltics
Beta Blocker or Verapamil for LV outflow obstruction
Surgical myectomy of septum

46
Q

What is the most common Glycogen Storage Disease of the Heart

A

Pompe Disease: Acid Maltase Absent

47
Q

Sx of Glycogen Storage Disease of Heart

A

Newborn will be well
Generalized muscle weakness, large tongue, cardiomegaly without murmur
Developmental/Growth Delays will be noted by 6 months, feeding problems, cardiac failure

48
Q

Tx of Glycogen Storage Disease of Heart

A

Enzyme Replacement, however most kids die by 1 yr

49
Q

What are two main components to syncope in kids

A

Hypotension and Bradycardia

50
Q

Dx of syncope

A

Head-up Tilt Table Testing

Classify as Vasodepressor (Hypotensive) or Cardioinhibitory (Bradycardia) or both

51
Q

Tx for Syncope

A 
Usually self-limited
Prevent hypovolemia by managing salt and fluid intake
Fludrocortison
Vagolytics: Disopyramide
SSRI to help with sx
52
Q

Tx for Hypertrophic Cardiomyopathy

A

Restrict from competitive exercise
Beta Blockers or Verapamil for LV outflow obstruction
Surgical myectomy of septum if very sx
Mitral valve repair/valve replacement

53
Q

Tetralogy of Fallot Dx

A

CXR: RV Hypertrophy, Concave pulmonary artery segment, aortic knob to right of trachea, decreased pulmonary vascular markings
EKG: QRS axis rightward
Echo: RV wall thickening, overriding aorta, large VSD
Cardiac Cath: Right to Left Shunt. Low pulmonary artery pressure

54
Q

Dx of Mitral Regurgitation

A

Blowing holosystolicc murmur located at Apex, radiates to left axilla

Pediatrics (12 decks)

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