Cardiology Flashcards
3 main/ extra things in fatal blood circulation
ductus arteriosus
ductus venosus
formane ovale
what happens to fetal circulation after brith?
pulmonary vascular resistance falls , pulmonary blood flow increase and the ductus and Forman ovale close
what is an innocent murmur?
murmur with no associated structural abnormality
incidence of innocent murmur
heard in up to third of children at some time
S of innocent murmur
whats the murmur like?
systolic soft does not radiate changes with posture often heard in febrile child (hyper dynamic circulation)
Ix in innocent murmur
re-examine when well
consider ECG
CXR
echo if thought to be significant
causes of cyanotic heart disease
ventricular septal defect patent ductus arteriosus atrial septal defect coarctation of the aorta aortic stenosis
causes of cyanotic heart disease
tetralogy of fallot
transposition of the great arteries
ventricular septal defect Sy
usually come on once shunt reversal has occurred dyspnoea chest pain syncope haemoptysis
Si ventricular septal defect
cyanosis
clubbing
loud pan systolic murmur
Ix VSD
echo
Tx VSD
spontaneous closure in about half of small ones
surgical correction when there is moderate/large left to right shunt
atrial septal defect Sy
usually asymptomatic until adulthood
palpitations (arrhythmias)
dyspnoea
cyanosis
atrial septal defect Si
heave
cyanosis
clubbing
Ix of ASD
ECG
CXR
echo
Rx of ASD
can be left
or
surgery
Tetralogy of Fallot pathology
- VSD
- Right ventricular hypertrophy
- overriding aorta
- right ventricular outflow tract obstruction (pulmonary stenosis)
PROVe
A of tetralogy of fallot
most common cyanotic heart disease congenital
associated with di George syndrome
S of tetralogy of fallot
cyanosis murmur cyanotic spells when crying / upset suat to increase venous returns clubbing
Ix of tetralogy of fallot
ECG
CXR boot shaped heart
echo
Rx of tetralogy of fallot
O2
morphine
propanolol
surgery
transposition of the great arteries
they swap
2 parallell circulations
mixing maintained by one of the 3 fatal circulation things
S of transposition of great arteries
cyanosis at birth or presentation when duct closes
Ix of transposition of great arteries
CXR
echo
Rx of transposition of great arteries
surgery
coarctation of aorta is associated with what birth defect?
Turners syndrome
S of coarctation of aorta
absent/ weak femoral pulses, hypertension in arms but not legs
Ix of correction of aorta
CXR
ECG
Echo
Rx of coarctation of aorta
surgical resection and anastomosis
prostaglandin E is critical to keep ductus open
