Cardiology Flashcards
Two examples of right to left shunt
Tetralogy of fallot
Transposition of the great arteries
Four features of tetralogy of fallot
Overriding aorta
Large VSD
R ventricular outflow tract obstruction due to subpulmonary stenosis
R ventricular hypertrophy
Baby with hypercyanotic spells, loud harsh ejection systolic murmur and a small heart on chest x ray
Tetralogy of fallot
Life threatening cyanosis on day two of life, egg on side cardiac contour and loud single second heart sound
Transposition of the great arteries - presents when duct closes
Cyanosis at birth progressing to heart failure within two weeks. No murmur heard but a superior axis on ECG
Complete atrioventricular septal defect - single 5 leaflet valve between atria and ventricles
Three forms of outflow obstruction in an otherwise well child
Aortic stenosis
Pulmonary stenosis
Adult type coarctation of the aorta
Initial management for transposition of the great arteries
Prostaglandin to maintain ductus
Small volume pulses with a carotid thrill and an ejection systolic murmur radiating to the neck.
Aortic stenosis
Ejection systolic murmur at the left sternal edge and an ejection click
Pulmonary stenosis
An asymptomstic ejection systolic murmur with radiofemoral delay no noticeable rib notching on chest X-ray
Adult type coarctation of the aorta - v uncommon
Three causes of outflow obstruction in the sick infant
Coarctation of the aorta
Interruption of the aortic arch
Hypoplastic left heart syndrome
Definition of coarctation of the aorta
Arterial duct tissue encircles the aorta at the point of the duct insertion therefore when the duct closes the aorta constricts –> severe obstruction to the left ventricular outflow
Acute circulatory collapse in a two day old neonate with absent femoral pulses and a severe metabolic acidosis
Coarctation of the aorta
Absent thymus, hypocalcaemia and an interrupted aortic arch
Di George syndrome
22q11.2 microdeletion
Di George syndrome
Short PR interval and delta waves on ecg
Wolff-Parkinson white
Narrow complex re entry tachycardia with heart rate of 250+
Supraventricular tachycardia
Management of supraventricular tachycardia - HR 250+, narrow complex
Circulatory and respiratory support
Vagal stimulation - carotid sinus massage
I.v. Adenosine
Electrical cardio version if adenosine fails.
Cause of congenital complete heart block
Anti ro and la antibodies
Inheritance of long QT
Autosomal dominant
Causes of syncope in a child
Neurogenic - vagal/prolonged standing Situational - cough/swallow Orthostatic Ischamic Arrhythmic - heart block or supraventricular tachycardia
Five features of rheumatic fever
Pancarditis - friction rub/tamponade Polyarthritis - 80% Sydenham chorea - 2 to 6 months later Erythema marginatum Subcutaneous nodules on extensor surfaces
Treatment of infective endocarditis
High dose penicillin and aminoglycoside for six weeks iv
Which children are at the highest risk of developing infective endocarditis
Those with turbulent blood flow i.e. VSD/coarctation
