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cardiology Flashcards

1
Q

what is transposition of great arteries

A

aorta is connected to the right ventricle and pulmonary artery is connected to left ventricle

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2
Q

what other CHD is transposiotion of the great arteires usually associated with

A

vsd

asd

pda

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3
Q

what is the presentation of transposiotion of the great arteires

A

not compatible with life unless another CHD is present

then:

cyanosis

loud 2nd HS

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4
Q

what findings would you find on xray with transposition of the great arteries

A

narrow mediastimun with an ‘egg’ on the side

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5
Q

what is the management of transposition of the great arteries

A

o2

maintain PDA w prostaglandins

surgery within days of life

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6
Q

what are complex CHD

A

rarer CHD most commonly tricuspid atresia with the R ventricle being small and innaffective

also:

mital atresia

double inlet L ventricle

Common arterial trunk

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7
Q

what is thepx of tricuspid atresia

A

like a common mixing CHD

cyanosis when newborn

breathlessness

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8
Q

what is the management of tricuspid atresia

A

shunt between subclavian and pulmonary artery for very cyanosed children + pulmonary artery binding

corrective surgery

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9
Q

what is a VSD

A

ventricular septal defects

most common CHD

defects antwhere in septum, perimembranes and muscle

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10
Q

what are the types of VSD

A

small (under 3mm)

large (larger than Ao valve)

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11
Q

what is the presentation of small VSD

A

asymptomatic with pansystolic murmur

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12
Q

what is the px of large VSD

A

herft failure - at 1 week old

  • breathlessness
  • faiulure to thrive

recurrent chest infections

tachycardia

tahyopnea

hepatomegaly

soft pansystolic murmur

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13
Q

what ix would you perform for VSD

A

usually all negative apart from echo but:

cxr

ecg

echo

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14
Q

what results may you find on CXR for VSD

A

cardiomegaly

enlarged pul

arteries

pulmonary oedema

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15
Q

how would you manage a VSD

A

surgery at 3-6m

if large = diuretics+captopril and high calorie diet

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16
Q

what is a PDA

A

patent ductus arteriosis

the ductus arteriosis is a part of fetal circulatory system, in PDA it remains open and doesnt close shortly after birth causing a L -> r shunt

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17
Q

what are the signs of a PDA

A

continous murmur at clavicle

collapsingpulse

failure to thrive

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18
Q

what may you find on CXR for PDA

A

cardiomegaly (biventricular hypertrophy)+ dilated pulmonary arteries

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19
Q

how would you treat a PDA

A

surgery at 1y

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20
Q

what type of CHD is AVSD

A

common mixing

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21
Q

what is AVSD

A

atrioventricular septal defect

a defect in the middle of the heart with a single 5 leafelet valve between the atria and the ventricles with a tendancy to leak

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22
Q

what is the presentation of AVSD

A

cyanosis at birth

heart failure at 2-3 weeks

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23
Q

what condition is avsd associated with

A

downs

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24
Q

how would you investigate AVSD

A

antenatal us

ecg

echo

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25
how would you manage an AVSD
diuretics + captopril high calorie diet surgery at 3-6m
26
what is tetrogy of fallot
most common cause of cyanotic CHD a right to left shunt has 4 cardinal features 1. overring aorta 2. large VSD 3. R ventricular hypertrophy 4. subpulmonary stenosis
27
what is the presentation of tetrogy of fallot
severe cyanosis with hypercyanotic spells finger clubbing harsh ejection systolic murmur
28
what are would you find on CXR of tetrogy of fallot
right ventricular hypertrophy overriding aorta small heart
29
what is the management of tetrogy of fallot
surgery at 6 m
30
what are hypercyanotic spells
fainting followed by sleep for 15 mins usually self limiting, intervene only if sleep is prolonged
31
what is the management of hypercyanotic spells
morphene iv propranolol iv fluids bicarbonate muscle paralysis and ventilation
32
what type of CHD is pulmonary stenosis
an outflow obstruction
33
what is pulmonary stenosis
pulmonary valve leaflets are partly fused together
34
what may you find on XRAY with pulmonary stenosis
post stenotic dilatation of pulonary artery right ventricular hypertrophy
35
what is the presentation of pulmonary stenosis
mostly asymptomatic unless critical pulmonary stenosis * ejection systolic murmur * r ventricular heave * cyanosis
36
what is the management of pulmonary stenosis
surgery onlyif critical/pressure gradient becomes too high
37
what is aortic stenosis
aortic valve leaflets are fused causing outflow obstruction
38
what other CHD is aortic stenosis commonly associated with
mitral valve stenosis coarctation of the aorta
39
what is the presentation of aortic stenosis
asymptomatic unless severe / critical severe = low excersise tolerence, chest pain, syncope critical = neonatal shock and HF
40
what are signs of aortic stenosis
slow risisng pulses carotid thrill ejection systolic murmur radiation to neck epical ejection click
41
what would you find on xray in aortic stenosis
prominent left ventricle(L ventricular hypertrophy) and post stenotic dilatation
42
what is the management of aortic stenosis
regular echo treat if symptomatic on excersise or a high pressure gradient surgery once in infancy and a valve replacement later in life
43
what type of CHD is coarctation of the aorta
an outflow obstruction
44
what is coarctation of the aorta
arterial duct tissue encirculating the aorta at the point of insertion of the arterial duct, so at constriction it causes outflow obstruction
45
what is the presentation of coarctation of the aorta
occurs after the duct closes at 2 days then: shock
46
what other CHD is commonly found with coarctation of the aorta
VSD
47
what murmur is present with coarctation of the aorta
ejection systolic murmur
48
how would yo diagnose coarctation of the aorta
x ray - usually normal abnormal ECG + echo
49
how do you treat coarctation of the aorta
surgery in first few days of life
50
what is ASD
a leeft to right shunt in the atria of the heart
51
what are the types of ASD
secundum partial
52
describe a secundum ASD
defect un the centre of the atrial septum involving the soramen ovale
53
what is a partial ASD
communication between bottom of the atrial septum and the atrioventricular valves, with a tendancy to regurgitate
54
what is the presentation of an ASD
arrythmias recurrent chest infections but mostly asymptomatic
55
what is the murmurs of ASD
**_pa_**rtial = **_pa_**nsystolic **_s_**ecundum = ejection _s_ystolic
56
what is the management of ASD
treat if symptomatic or have a dilated right ventricle surgery at 3-5y
57
what would you find on x ray is ASD
cardiomegaly w enlarged pulmonary arteries
58
what would you find on ECG on secundum ASD
RBBB
59
what would you find on ecg on pASD
superior QRS
60
what is heart failure
inability of the heart to meeet the bodys demands
61
what is the presentation of heart failure
breathlessness + poor feeding leading to failure to thrive sweating tachycardia and tachyopnea recurrent chest infections gallop rythmn murmur cardiomegaly hepatomegaly
62
what are the causes of left sided heart failre
younger than 1 week = coarctation of the aorta (ie L sided obstruction) older than 1w= left to right shunts, pulmonary vascular resistance will fall increasing shunting and causing HTN
63
what is Eisenmengers syndrome
untreated HF due to L\>R shunt leading to pulmonary HTN
64
how do you treat HF
digoxin diuretics ACEi BBlockers
65
what is rhumatic fever
inflammatory disease of the heart that can develop with untreated strep infections
66
what is the Jones criteris
a way of classifying rheumatic fever based on severity of Sx can be major or minor
67
what is the presentation of minor RF
fever polyarthria raised inflam markers prolonged PR interval
68
what are the features/ presentations of major rheumatic fever
pancarditis endocarditis = murmur myocarditis = oedema / HF pricarditis= pleural rub polyarthritis sudden chorea emotional liability
69
how do you investigate rheumatic fever
echo
70
how do you manage rheumatic fever
bedrest asprin +/- corticosteriods diuretics ACEi treat infections with Benzathine penicillin + PO erthromycin +/- dain pericardial effusion
71
what is a consequece of prolonged rheumatic fever
mitral stenosis
72
what are the Rf for bacterial endocarditis
CHD's - due to turnulent blood flows but not secundum ASD
73
what is the presentation of bacterial endocarditis
fever anaemia splinter haemorrages necrotic skin lesions splenomegaly cerebral and retinal infarcts arthritis microscopic haematuria
74
how would you diagnose bacterial endocarditis
blood cultures : ESR, CRP, FBC echo
75
what is the most common cause of bacterial endocarditis
strep. viridant
76
what is the treatement for strep. viridans bacterial endocarditis
IV penecillin for 6 weeks + aminoglycodised surgery if they have prothetic HV

Phase 3a (22 decks)

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