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Phase 3a > cardiology > Flashcards

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
Q

how would you manage an AVSD

A

diuretics + captopril

high calorie diet

surgery at 3-6m

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26
Q

what is tetrogy of fallot

A

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
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27
Q

what is the presentation of tetrogy of fallot

A

severe cyanosis with hypercyanotic spells

finger clubbing

harsh ejection systolic murmur

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28
Q

what are would you find on CXR of tetrogy of fallot

A

right ventricular hypertrophy

overriding aorta

small heart

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29
Q

what is the management of tetrogy of fallot

A

surgery at 6 m

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30
Q

what are hypercyanotic spells

A

fainting followed by sleep for 15 mins

usually self limiting, intervene only if sleep is prolonged

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31
Q

what is the management of hypercyanotic spells

A

morphene

iv propranolol

iv fluids

bicarbonate

muscle paralysis and ventilation

32
Q

what type of CHD is pulmonary stenosis

A

an outflow obstruction

33
Q

what is pulmonary stenosis

A

pulmonary valve leaflets are partly fused together

34
Q

what may you find on XRAY with pulmonary stenosis

A

post stenotic dilatation of pulonary artery

right ventricular hypertrophy

35
Q

what is the presentation of pulmonary stenosis

A

mostly asymptomatic

unless critical pulmonary stenosis

  • ejection systolic murmur
  • r ventricular heave
  • cyanosis
36
Q

what is the management of pulmonary stenosis

A

surgery onlyif critical/pressure gradient becomes too high

37
Q

what is aortic stenosis

A

aortic valve leaflets are fused causing outflow obstruction

38
Q

what other CHD is aortic stenosis commonly associated with

A

mitral valve stenosis

coarctation of the aorta

39
Q

what is the presentation of aortic stenosis

A

asymptomatic unless severe / critical

severe =

low excersise tolerence, chest pain, syncope

critical = neonatal shock and HF

40
Q

what are signs of aortic stenosis

A

slow risisng pulses

carotid thrill

ejection systolic murmur radiation to neck

epical ejection click

41
Q

what would you find on xray in aortic stenosis

A

prominent left ventricle(L ventricular hypertrophy) and post stenotic dilatation

42
Q

what is the management of aortic stenosis

A

regular echo

treat if symptomatic on excersise or a high pressure gradient

surgery once in infancy and a valve replacement later in life

43
Q

what type of CHD is coarctation of the aorta

A

an outflow obstruction

44
Q

what is coarctation of the aorta

A

arterial duct tissue encirculating the aorta at the point of insertion of the arterial duct, so at constriction it causes outflow obstruction

45
Q

what is the presentation of coarctation of the aorta

A

occurs after the duct closes at 2 days

then:

shock

46
Q

what other CHD is commonly found with coarctation of the aorta

A

VSD

47
Q

what murmur is present with coarctation of the aorta

A

ejection systolic murmur

48
Q

how would yo diagnose coarctation of the aorta

A

x ray - usually normal

abnormal ECG + echo

49
Q

how do you treat coarctation of the aorta

A

surgery in first few days of life

50
Q

what is ASD

A

a leeft to right shunt in the atria of the heart

51
Q

what are the types of ASD

A

secundum

partial

52
Q

describe a secundum ASD

A

defect un the centre of the atrial septum involving the soramen ovale

53
Q

what is a partial ASD

A

communication between bottom of the atrial septum and the atrioventricular valves, with a tendancy to regurgitate

54
Q

what is the presentation of an ASD

A

arrythmias

recurrent chest infections

but mostly asymptomatic

55
Q

what is the murmurs of ASD

A

partial = pansystolic

secundum = ejection _s_ystolic

56
Q

what is the management of ASD

A

treat if symptomatic or have a dilated right ventricle

surgery at 3-5y

57
Q

what would you find on x ray is ASD

A

cardiomegaly w enlarged pulmonary arteries

58
Q

what would you find on ECG on secundum ASD

A

RBBB

59
Q

what would you find on ecg on pASD

A

superior QRS

60
Q

what is heart failure

A

inability of the heart to meeet the bodys demands

61
Q

what is the presentation of heart failure

A

breathlessness + poor feeding leading to failure to thrive

sweating

tachycardia and tachyopnea

recurrent chest infections

gallop rythmn murmur

cardiomegaly

hepatomegaly

62
Q

what are the causes of left sided heart failre

A

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
Q

what is Eisenmengers syndrome

A

untreated HF due to L>R shunt leading to pulmonary HTN

64
Q

how do you treat HF

A

digoxin

diuretics

ACEi

BBlockers

65
Q

what is rhumatic fever

A

inflammatory disease of the heart that can develop with untreated strep infections

66
Q

what is the Jones criteris

A

a way of classifying rheumatic fever based on severity of Sx

can be major or minor

67
Q

what is the presentation of minor RF

A

fever

polyarthria

raised inflam markers

prolonged PR interval

68
Q

what are the features/ presentations of major rheumatic fever

A

pancarditis

endocarditis = murmur

myocarditis = oedema / HF

pricarditis= pleural rub

polyarthritis

sudden chorea

emotional liability

69
Q

how do you investigate rheumatic fever

A

echo

70
Q

how do you manage rheumatic fever

A

bedrest

asprin +/- corticosteriods

diuretics

ACEi

treat infections with Benzathine penicillin + PO

erthromycin

+/- dain pericardial effusion

71
Q

what is a consequece of prolonged rheumatic fever

A

mitral stenosis

72
Q

what are the Rf for bacterial endocarditis

A

CHD’s - due to turnulent blood flows

but not secundum ASD

73
Q

what is the presentation of bacterial endocarditis

A

fever

anaemia

splinter haemorrages

necrotic skin lesions

splenomegaly

cerebral and retinal infarcts

arthritis

microscopic haematuria

74
Q

how would you diagnose bacterial endocarditis

A

blood cultures : ESR, CRP, FBC

echo

75
Q

what is the most common cause of bacterial endocarditis

A

strep. viridant

76
Q

what is the treatement for strep. viridans bacterial endocarditis

A

IV penecillin for 6 weeks

+ aminoglycodised

surgery if they have prothetic HV

Phase 3a (22 decks)

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