Cardiology Flashcards
What are the common congenital heart diseases?
VSD Patent ductus areriosus ASD Pulmonary stenosis Aortic stenosis Coarctaion of the aorta Transposition of the great vessels Tetralogy of Fallot
What ar the causes of congenital heart disease?
Genetic susceptibility
Environmental hazard
Teratogenic insult
What environmental hazards can cause congenital heart disease?
Drugs
Infections
Maternal disease
What infections can cause congenital heart disease?
Toxoplasmosis
Rubella
CMV
Herpes
At what stage to teratogenic insults cause congenital heart disease?
18-60 days post conception
What % of murmurs are innocent?
70-80%
What are the types of innocent murmur?
Still’s
Pulmonary outflow
Carotid bruits
Venous hum
What are the common features of innocent murmurs?
Systolic murmur Soft murmur Vibratory, musical, localised Varies with position, respiration and exercise No other signs of cardiac disease
What is the presentation of Still’s murmur?
Age 2-7
Soft systolic, vibratory, twangy murmur
At apex and left sternal border
Increase in supine position and with exercise
What is the presentation of a pulmonary outflow murmu?
Age 8-10 Soft systolic, vibratory, well localised Upper left sternal border, no radiation Increase in supine position and with exercise Often in children with narrow chest
What is the presentation of innocent carotid bruits?
Age 2-10 Systolic, harsh, radiated to neck Supraclavicular Increases with exercise Decreases on turning head or extending neck
What ar the 3 main types of VSD?
Subaortic
Perimembranous
Muscular
What i the clinical presentation of VSD?
Pansystolic murmur- lower left sternal edge
Sometimes thrill
Small= early systolic murmur
Large= Diastolic rumble, signs of cardiac failure- biventricular hypertrophy, pulmonary hypertension
What is the treatment of VSD?
Closure- Abplatzen device
Patch closure
What are the clinical features of ASD?
Few in early childhood- good chance of spontaneous closure Adult- AF, heart failure Pulmonary hypertension Wide fixed splitting of 2nd heart sound Pulmonary flow murmur
What is the treatment od ASD?
Closure
What isa atrio-ventricular septal defect?
Singular AV valve with osmium premium ASD and high VSD
What is atrio-ventricular septal defects associated with?
Trisomy 21
What are the clinical features of pulmonary stenosis?
Asymptomatic in mild
Moderate and severe- severe exertion dyspnoea, fatigue
Ejection systemic murmur at upper left sternal border with radiation to back
What is the treatment of pulmonary stenosis?
Balloon valvoplasty
What are the features of aortic stenosis?
Mostly asymptomatic
Severe- reduced exercise tolerance, exertion chest pain, syncope
Ejection systolic murmur upper right sternal border, radiation o carotids
What can cause atrial stenosis?
Tricuspid aortic valve
What is the treatment of aortic stenosis?
Balloon aortic valvuloplasty
Who is patent ductus arteriosus common in?
Pre term babies
What is the treatment of patent ductus arteriosus?
Fluid restriction/diuretics
Prostaglandin inhibitors
Surgical ligation
What is the treatment of patent ductus arteriosus in term babies?
Closure with umbrella device
What investigations are done for coarctation of aorta?
Echo
MRI
What is the management of coarctation of the aorta?
Reopen PDA with prostaglandin E1 or E2
Resection with end to end anastomoses
Subclavian patch repair
Balloon aortoplasty
What is transposition of th great vessels?
Aorta connected to RV, pulmonary artery connected to LV
What is the treatment of transposition of the great vessels?
Switch procedure
What are the 4 malformations in tetralogy of Fallot?
Overriding aorta
Pulmonary stenosis
VSD
Right ventricular hypertrophy
