Cardiology

Question 1

When is Rubella most concern antenatally? Cardiac consequences?

Answer 1

1st trimester

PDA, pulmonary valve issues, VSD

Question 2

What is the cardiac association with maternal diabetes?

Answer 2

Assymetric hypertrophic cardiomyopathy

Question 3

Is a 2/6 or louder murmur in the first 24 hours of life a concern?

Answer 3

Yes this is more likely to be pathological. In the following few days can be due to physiological TR / pulmonary vascular resistance / closing PDA

Question 4

What is the normal difference between upper limb and lower limb BP?

Answer 4

Lower limb BP is usually 10-20 mmHg higher than upper limb. If upper limb higher, need to rule out coarctation

Question 5

Are the brachial or femoral pulses normal to feel first?

Answer 5

Femoral pulses in an otherwise normal child

Question 6

Still’s murmur (vibratory, LSE - upper or lower, may have iRBBB/normal ECG and CXR and exam) is louder in erect or supine position?

Answer 6

Louder when supine