Cardiology Flashcards
what are innocent murmurs
“flow murmurs” - caused by fast flow during systole
features of innocent murmurs
4 ‘S’s
- Soft
- Short
- Systolic
- Symptomless
what are the 3 shunts of the foetal circulation
ductus venosus – connects umbilical vein to inferior vena cava
foramen ovale – connects right atrium to left atrium
ductus arteriosus – connects pulmonary artery to aorta
what causes the foramen ovale to close at birth
first few breaths the baby takes causes alveoli to expand – decreasing pulmonary vascular resistance
this decreased resistance causes pressure to drop in right atrium
left pressure > right pressure causes collapse of atrial septum
duct becomes sealed shut and becomes the fossa ovalis
what causes the ductus arteriosus to close
needs prostaglandins to remain open
increasing blood oxygenation causes prostaglandins to drop – closure of duct to ligamentum arteriosum
what is a patent ductus arteriosus (PDA)
failure of ductus arteriosus to close between pulmonary trunk + aorta
causes left to right shunt
risk factors for PDA
prematurity
maternal rubella infection
murmur in PDA
continuous machinery like murmur
- left subclavicular thrill
- bounding, collapsing pulse
management of PDA
indomethacin – inhibits prostaglandin synthesis so closes the duct
what is an atrial septal defect
hole in the septum between the two atria
most common atrial septal defect
ostium secundum
murmur heard in atrial septal defect
mid systolic crescendo- decrescendo with fixed split second heart sound
ECG changes with ostium secondum
RBBB with RAD
presentation of atrial septal defect in adulthood
asymptomatic in childhood but can cause - dyspnoea - right heart failure - stroke in adulthood
most common form of congenital heart disease
ventricular septal defect
what conditions are associated with a ventricular septal defect
Downs syndrome
Edwards syndrome
Patau syndrome
murmur heard in ventricular septal defect
pan systolic murmur at left sternal edge
what is cortication of the aorta
narrowing of descending aorta
signs of cortication of aorta
radio-femoral delay
rib notching on CXR
systolic murmur over left scapula
what conditions are associated with coartication of aorta
Turners syndrome
Bicuspid aortic valve
Neurofibromatosis
Berry aneurysms
what are the cyanotic congenital heart diseases
tetralogy of Fallot
transposition of great arteries
what is tetralogy of fallot
Ventricular septal defect
Overriding aorta
Pulmonary valve stenosis
Right ventricular hypertrophy
signs of tetralogy of fallot
cyanosis due to right to left shunt
ejection systolic murmur due to pulmonary stenosis
Boot shaped heart on CXR
right ventricular hypertrophy on ECG
What is given in cyanotic heart disease until surgery can be performed
prostaglandins
what is eisenmengers syndrome
reversal of a left to right shunt due to pulmonary HTN, resulting in a right to left shunt can be caused by - ventricular septal defect - atrial septal defect - patent ductus arteriosus
signs of eisenmengers syndrome
cyanosis
haemoptysis
clubbing
Right ventricular failure
what is Ebsteins anomaly
triscupid valve set lower in right side of heart
causes a bigger right atrium and a small right ventricle
this causes poor blood flow
- associated with Wolf Parkinson White syndrome
what does a ventricular septal defect increase risk of
Endocarditis
supravalvular aortic stenosis is seen in which genetic condition
Williams Syndrome
cardiac complication of Fragile X
Mitral valve prolapse
cardiac complication of Duchenne muscular dystrophy
cardiomyopathy
what drug taken in pregnancy can cause an Ebstein anomaly
Lithium
most common cause of hypertension in children
renal parenchymal disease
features of a Venous hum
continuous blowing murmur below clavicles
