Cardiology Flashcards
8 commonest lesions
VSD PDA ASD Pulmonary stenosis aortic stenosis coarctation of aorta transposition of great arteries tetralogy of fallot
Environmental factors for causing cardiac defects
Drugs eg alcohol, phenytoin
infections - TORCH
Maternal eg DM, SLE
TORCH infections
toxoplasma
rubella
CMV
herpes
What cardiac anomaly is down associated with?
AVSD
Investigations
blood pressure ABG CXR Echo catheter angiography MRI/A Exercise test
Common features of innocent murmurs
systolic no other signs of cardiac disease soft murmur - grade 1/6 or 2/6 vibratory, musical localised varies with position, resp, exercise
4 innocent murmurs
stills - LV outflow
pulmonary outflow
carotid/brachiocephalic arterial bruits
venous hum
Stills murmur
age 2-7
soft systolic, vibratory
apex, left sternal border
increases in supine + exercise
pulmonary outflow murmur
age 8-10 upper left sternal border increases in supine and exercise children with narrow chest systolic, vibratory
carotid/brachiocephalic bruits
age 2-10yrs 1-6/2-6 --> harsh supraclavicular and radiates to neck increase with exercise decrease on turning head
venous hum
age 3-8yrs soft, indistinct continuous murmur supraclavicular only in upright position disappear lying down or turning head
VSD 3 main types and direction of shunt
subaortic
perimembranous
muscular
L to R shunt
presentation of VSD
Pansystolic murmur - lower left sternal edge with thrill
signs of cardiac failure and diastolic rumble if large
effect of VSD on heart
biventricular hypertrophy
pulmonary hypertension
How to close a VSD
amplatzer device
patch closure
ASD presentation
adult: with AF, heart failure
wide fixed splitting of 2nd heart sound
pulmonary outflow murmur
What is AVSD?
ostium primum ASD
high VSD
presentation of pulmonary stenosis
exertional fatigue and dyspnoea
ejection systolic upper left sternal border
radiate to back
treating pulmonary stenosis
balloon valvoplasty
Changes in fetal circulation at birth
pulmonary resistance falls
pulmonary blood flow rises
Ductus arteriosus close
Foramen ovale close
PDA treatment
fluid restriction
prostaglandin inhibitors
surgery
Managing aortic coarctation
re open PDA with prostaglandin E1+2
resection
subclavian patch repair
balloon aortoplasty
tetralogy of fallot
pulmonary stenosis
VSD
right ventricular hypertrophy
overriding aorta
