Cardiology Flashcards
Which defect is associated with wide fixed splitting of S2?
ASD - due to equal volume of blood in RV during inspiration & expiration (normally there is more on inspiration)
What are the acyanotic heart defects? What is they key symptom?
VSD, ASD, PDA. Breathless (left to right shunts)
Which condition is associated with increased risk of bacterial endocarditis?
Small VSD
What does a small VSD sound like?
Loud pansystloic murmur at L sternal edge
What are the symptoms + signs of a large VSD?
Symptoms: HF, SOB and FTT from 1w onwards. Presents in first 2 months of life. Recurrent chest infections, hepatosplenomegaly.
Signs: quiet pan systolic murmur L sternal edge, increased HR + RR
A 48y/o lady has presented with recent onset AF. Upon echo, a heart defect is noted. What likely defect does she have?
ASD
What features may be visible on a CXR of VSD or ASD?
Cardiomegaly, enlarged pulmonary As, increased pulmonary vascular markings
When might you see a collapsing/bounding pulse?
PDA (due to volume overload)
What are the auscultation signs in PDA?
Machine hum murmur, heard loudest under L clavicle –> radiates to back
At what age must PDA be operated on if not closed?
by 1y
What non-surgical options are there for Tx of PDA?
Ibuprofen –> opposes effects of pristine
Prostaglandin inhibitor e.g. indomethacin
When is a cyanotic heart defect likely to present?
Within 1st week of life
What are the main cyanotic heart defects?
Transposition of great As, tetralogy of fallot’s,
When does the ductus arteriosus usually close?
Within 1st 2 days of life
What is the classic radiological findings of transposition great As?
Looks like an egg on the side, narrow mediastinum, increased pul vascular markings
What murmur may be heard with ToF?
Ejection systolic murmur - due to pul stenosis
A 3 day old baby suddenly becomes very pale and breathless. After a minute or so he returns to normal. What is this?
A cyanotic (Tet) spell - closure of ductus arteriosus around day 2/3 causes R–>L shunt –> sudden SOB, irritable, cyanosed, pale, poss lose consciousness briefly.
However, spells do not last long as the overriding aorta means blood can still get from LA to aorta.
What are the CXR features of ToF?
Small heart, boot shaped
How can tet spells be managed?
Usually self-limiting, followed by period of sleep. If longer than 15 mins: - sedation & pain relief - IV propanolol - Oxygen - If acidotic --> bicarbonate
What defect is associated with Down’s?
AVSD - often no murmur. Progressive HF over 1-2 months of life –> rapid breathing, nasal flaring during feeding, FTT
What condition is aortic coarctation associated with?
Turner’s
What are the signs of aortic coarctation?
Examination on day 1 = normal.
When DA closes –> constricts aorta –> circulatory collapse, severe HF, weak femoral, metabolic acidosis, renal failure
Which organism is assoc with bacterial endocarditis? How is it Tx?
Strep viridans.
Tx = gentamicin + penicillin for 6w
