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Pediatrics > Cardiology > Flashcards

Cardiology Flashcards

1
Q

Still’s murmur

A

Innocent SYSTOLIC heart murmur best heard at the mid-left sternal border at age 2-7 years

  • Loudest supine and with exercise
  • Vibratory, buzzing sound
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2
Q

Pulmonic systolic murmur

A

Innocent pediatric heart murmur at the upper left sternal border

  • Loudest supine and with exercise
  • Sounds blowing and high-pitched
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3
Q

Venous hum

A

Innocent pediatric heart murmur found at the neck and below the clavicles

  • Continuous murmur that disappears when supine
  • Changes with compression of the jugular vein
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4
Q

ASD

A

Findings: Systolic ejection murder, fixed split S2, diastolic rumble at LLSB

EKG: RAD, RVH, RAE

CXR: RAE, RVH, Increased PVM

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5
Q

VSD

A

Findings: High pitched, holosytolic murmur at LLSV, diastolic rumble at apex if pulmonary blood flow is high, possible eisenmeger syndrome

EKG: LVH, RVH if pulmonary hypertension is present

CXR: Cardiomegaly, increased PVM

Tx: CHF management (digoxin, dopamine, diuretics)

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6
Q

PDA

A

Findings: Continuous murmur at ULSB, brisk pulses, high incidence in preemies

EKG: LVH, RVH is pulmonary HTN is present

CXR: Cardiomegaly, increased PVHM

Tx: Indomethacin

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7
Q

Aortic coarction

A

Findings: Strong upper pulses/weak lower pulses, dampened and delayed femoral pulse, bruit on upper left back, usually before the PDA so infants can have lower body perfusion, may have bicuspid aorta

EKG: Maybe LVH

CXR: Rib notching

Tx: PGE, dopamine, balloon angioplast

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8
Q

Aortic stenosis

A

Findings: Ejection click, systolic ejection murmur at base w/ radiation to URSB, apex, surasternal notch, and carotids, thrill at URSB and suprasternal notch, may be assoc. w/ hypoplasia of the left ventricle

EKG: Maybe LVH

CXR: Prominent ascending aorta

Tx: Balloon valvuloplasty, surgery, Ross procedure (replace w/ pulmonary valve)

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9
Q

Pulmonary stenosis

A

Findings: Ejection click, systolic ejection murmur at ULSB

EKG: RVH

CXR: Prominent pulmonary artery

Tx: Balloon valvuloplasty

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10
Q

Causes of central cyanosis (5 T’s)

A
  1. Truncus arteriosus
  2. Transposition of the great arteries
  3. Tricuspid atresia
  4. TOF
  5. TAPVC
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11
Q

TOF

A

Findings: Systolic ejection murmur of pulmonary stenosis (determines severity)

EKG: RVH

CXR: Boot shaped heart (upturned apex), decreased PVM, right aortic arch

Tx: Surgery, Blalock-Taussig shunt (graft b/w subclavian and ipsilateral pulmonary artery)

Tx for tet spell: Relax, knee to chest, IV bolus, O2, propanolol

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12
Q

Transposition of the great arteries

A

Findings: Single S2, normally a PFO at birth

EKG: Maybe RVH

CXR: Small heart with a wide mediastinum (egg on a string), increased PVM

Tx: PGE, balloon atrial septostomy, arterial switch surgery

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13
Q

Tricuspid atresia

A

PE: Single S2, possible VSD so maybe holosystolic, always has an ASD or PFO

*If ventricular septum intact, pulmonary atresia present

EKG: LAD, RAE, LVH

CXR: Small heart, decreased PVM

Tx: Fontan procedure (IVC directed to pulmonary arteries)

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14
Q

Truncus arteriosus

A

PE: Single S2, systolic ejection murmur along LSB, diastolic murmur at apex

EKG: CVH (combined ventricular hypertrophy)

CXR: Enlarged heart, increased PVM, right aortic arch

Tx: CHF tx.

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15
Q

Total anomalous pulmonary venous connection

A

PE: Pulmonary ejection murmur along LSB, pulmonary veins drain into systemic venous side rather than LA and flows across a PFO or ASD

EKG: RVH, RAE

CSR: Enlarged heart in older children (snowman appearance), increased PVM

Tx: Surgery

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16
Q

MCC of infective endocarditis

A

Bacterial: Strep. viridans, Staph

17
Q

Infective endocarditis signs/symptoms

A 
Fever
Roth spots
Osler nodes (swollen lesions on palms, soles, pads of toes) 
Microscopic hematuria 
Janeway lesions (erythematous, hemorrhagive lesions on palms) 
Arthralgia
Nail hemorrhages 
End-organ failure
18
Q

Prophylaxis for endocarditis

A

All pts. w/ structural heart disease (except osteum secundum ASD)

All postoperative cardiac surgery repair pts. for 6 mnths

all postoperative cardiac surgery pts. for indefinite period if hemodynamic residua remains

19
Q

Tx of pericarditis

A

Pericardiocentesis (diagnostic and therapeutic)

Anti-inflammatories

(MCC of pericarditis is viral infxn)

20
Q

Most typical finding of hypertrophic cardiomyopathy

A

Asymmetric septal hypertrophy

21
Q

Mc dysrhythmia in childhood

A

SVT

originates proximal to the bundle of His

22
Q

Wenckebach

A

Type I second degree AV block (progressive)

23
Q

Congenital third-degree AV block association

A

Occurs in babies born to mothers w. SLE

24
Q

AR Long QT syndrome

A

Jervell-Lange-Nielson syndrome

25
Q

AD Long QT syndrome

A

Romano-Ward syndrome

26
Q

MCC of cardiac chest pain in kids

A

Pericarditis

Pediatrics (9 decks)

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