Cardiology Flashcards
Symptoms of cardiac failure (4)
Breathlessness
Sweating
Poor feeding
Recurrent chest infections
Signs of cardiac failure (8)
Poor W gain Incr HR Incr RR Heart murmur Gallop rhythm Cardiomegaly Hepatomegaly Cool peripheries
When are cardiac abnormalities picked up antenatally?
Routine scan 18-20 weeks
HR <1 y/o
110-160
HR 2-5 y/o
95-140
HR 5-12 y/o
80-120
HR 12+ y/o
60-100
Cardiac abnormalities in older children (3)
Eisenmenger syndrome
Rheumatic heart disease
Cardiomyopathy
Cause of Eisenmenger syndrome
Untreated L–>R shunt
Effect of Eisenmenger syndrome (3)
Pulmonary HTN
R –> L shunt
Blue teen - cyanosis
Tx Eisenmenger syndrome
Heart-lung transplant
General Mx heart failure (6)
Bed position - semi-upriht O2 Sufficient kcal Diuretics + ACEi B-blockers + digoxin PG infusion (if duct dependent)
LLSE
Tricuspid valve
ULSE
Pulmonary valve
URSE
Aortic valve
MSLE
Mitral valve
What % of children will have an innocent murmur
30%
Features of an innocent murmur (S’s)
Asymptomatic patient Short duration Systolic only L Sternal edge No added heart sounds No thrill No radiation
3 types of innocent murmurs (3)
Venous hum
Flow
Musical
Where is venous hum
ULSE - above Right clavicle
How to stop venous hum
Supine position
If patient turns head
Where is flow murmur
MLSE
What causes a flow murmur?
Acute fever
Where is a musical murmur
LLSE
Features of a pathological murmur (4)
All diastolic/pan-systolic
Loud >3/6
Continuous
Associated abnormalities
S+S of pathological murmur (5)
SOB Tired/fatigue FTT Cyanosis CLubbing/hepatomegaly
L –> R lesions (3)
VSD
PDA
ASD
R –> L lesions (2)
TOF
Transposition of GA
Mixing lesion (1)
Complete AV septal defect
Outflow obstruction - well child (2)
Pulmonary stenosis
Aortic stenosis
Outflow obstruction - sick child (1)
CoA
Causes of cardiac lesions (10)
Familial Chromosomal: Downs Chromosomal: Edwards Syndromes: Williams, Syndromees: Turners Intrauterine infections - rubella Meds Maternal disease Alcohol/Drugs Childhood infections Kawasaki
What are the 3 shunts in the foetus?
Ductus venosus Foramen ovale (FO) Ductus ateriosus (DA)
Role of ductus venosus
Umbilical vv –> IJV
For O2’d blood to enter heart
Role of foramen ovale
RA –> LA
Role of ductus arteriosus
Pulm aa–> Aorta
What 3 things close the ductus arteriosus?
O2
Bradykinin
Indomethacin
What 3 things keep the ductus arteriosus open?
Decr O2
Premature baby
PG E2