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CP2 PAEDS > Cardiology > Flashcards

Cardiology Flashcards

1
Q

Symptoms of cardiac failure (4)

A

Breathlessness
Sweating
Poor feeding
Recurrent chest infections

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2
Q

Signs of cardiac failure (8)

A 
Poor W gain 
Incr HR 
Incr RR
Heart murmur 
Gallop rhythm 
Cardiomegaly
Hepatomegaly 
Cool peripheries
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3
Q

When are cardiac abnormalities picked up antenatally?

A

Routine scan 18-20 weeks

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4
Q

HR <1 y/o

A

110-160

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5
Q

HR 2-5 y/o

A

95-140

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6
Q

HR 5-12 y/o

A

80-120

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7
Q

HR 12+ y/o

A

60-100

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8
Q

Cardiac abnormalities in older children (3)

A

Eisenmenger syndrome
Rheumatic heart disease
Cardiomyopathy

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9
Q

Cause of Eisenmenger syndrome

A

Untreated L–>R shunt

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10
Q

Effect of Eisenmenger syndrome (3)

A

Pulmonary HTN
R –> L shunt
Blue teen - cyanosis

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11
Q

Tx Eisenmenger syndrome

A

Heart-lung transplant

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12
Q

General Mx heart failure (6)

A 
Bed position - semi-upriht 
O2 
Sufficient kcal 
Diuretics + ACEi 
B-blockers + digoxin 
PG infusion (if duct dependent)
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13
Q

LLSE

A

Tricuspid valve

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14
Q

ULSE

A

Pulmonary valve

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15
Q

URSE

A

Aortic valve

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16
Q

MSLE

A

Mitral valve

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17
Q

What % of children will have an innocent murmur

A

30%

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18
Q

Features of an innocent murmur (S’s)

A 
Asymptomatic patient 
Short duration 
Systolic only 
L Sternal edge
No added heart sounds 
No thrill 
No radiation
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19
Q

3 types of innocent murmurs (3)

A

Venous hum
Flow
Musical

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20
Q

Where is venous hum

A

ULSE - above Right clavicle

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21
Q

How to stop venous hum

A

Supine position

If patient turns head

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22
Q

Where is flow murmur

A

MLSE

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23
Q

What causes a flow murmur?

A

Acute fever

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24
Q

Where is a musical murmur

A

LLSE

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25
Q

Features of a pathological murmur (4)

A

All diastolic/pan-systolic
Loud >3/6
Continuous
Associated abnormalities

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26
Q

S+S of pathological murmur (5)

A 
SOB
Tired/fatigue 
FTT
Cyanosis 
CLubbing/hepatomegaly
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27
Q

L –> R lesions (3)

A

VSD
PDA
ASD

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28
Q

R –> L lesions (2)

A

TOF

Transposition of GA

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29
Q

Mixing lesion (1)

A

Complete AV septal defect

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30
Q

Outflow obstruction - well child (2)

A

Pulmonary stenosis

Aortic stenosis

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31
Q

Outflow obstruction - sick child (1)

A

CoA

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32
Q

Causes of cardiac lesions (10)

A 
Familial 
Chromosomal: Downs 
Chromosomal: Edwards 
Syndromes: Williams, 
Syndromees: Turners 
Intrauterine infections - rubella 
Meds 
Maternal disease 
Alcohol/Drugs 
Childhood infections 
Kawasaki
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33
Q

What are the 3 shunts in the foetus?

A 
Ductus venosus 
Foramen ovale (FO)
Ductus ateriosus (DA)
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34
Q

Role of ductus venosus

A

Umbilical vv –> IJV

For O2’d blood to enter heart

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35
Q

Role of foramen ovale

A

RA –> LA

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36
Q

Role of ductus arteriosus

A

Pulm aa–> Aorta

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37
Q

What 3 things close the ductus arteriosus?

A

O2
Bradykinin
Indomethacin

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38
Q

What 3 things keep the ductus arteriosus open?

A

Decr O2
Premature baby
PG E2

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39
Q

In what situation would you want the DA to remain open?

A

Duct-dependent lesions:

CoA
TGA
PS/AS/ atresia

40
Q

Changes to foetal circulation at birth

A 
Initiation by 1st breath 
--> Incr pulmonary blood flow --> incr P in LA 
Decr placental circ --> FO closes 
Closure DA
Closure umbilical aa 
Closure of DV
41
Q

Why does the umbilical aa close at birth?

A

Mechanical/thermal changes

42
Q

3 holes

43
Q

3 blocked pipes

44
Q

3 blue babies

A

TOF
ToGA
Common mixing

45
Q

What are the 2 types of ASD

A

Secundum (80%)

Partial AVSD

46
Q

What is ASD Secundum

A

Defect in centre of atrial septum involving FO

47
Q

What is partial AVSD?

A

Defect in AV septum

48
Q

Symptoms ASD (3)

A

Commonly none
Recurrent Chx infection
Wheeze

49
Q

Signs ASD (3)

A

Ejection systolic murmur
Split 2nd heart sound
If partial - pansystolic murmur @ apex

50
Q

Ix ASD

A

CXR (cardiomegaly)
ECG (RBBB secundum, sup QRS for partial)
Echo***

51
Q

Mx ASD - secundum

A

Cardiac catheterisation

52
Q

Mx ASD - partial

A

Surgical correction

53
Q

What % congenital heart disease is VSD?

54
Q

Features of a small VSD <3mm (2)

A

Asymp

Pansystolic murmur @ LLSE

55
Q

Mx small VSD (2)

A

Lesions close spontaneously

Follow up by pediatrician/cardiologist

56
Q

Size of a large VSD

A

Same/bigger than aortic valve

57
Q

Features of large VSD (6)

A 
Failure + breathlessness after 1 week
Tachypnoea 
Tachycaria
ENlarged liver 
Soft pansystolic murmur 
Thrills over heart
58
Q

Ix Large VSD (3)

A

CXR - cardiomeg, enlarged PA, oedema
ECG - hypertrophy
Echo

59
Q

Mx large VSD (3)

A

Diuretics
Incr Kcal
Surgery @3-6m to prevent Eisenmenger’s

60
Q

Features PDA (2)

A

Continuous murmur beneath clavicle

Bounding pulse

61
Q

Ix PDA (3)

A

ECG
CXR
ECho

62
Q

Mx PDA (2)

A

Close w/ indomethocin @1yr
OR
Surgical ligation

63
Q

What is a complete AVSD

A

Large defect in middle of atrial septum –> ventricular septum

64
Q

Features AVSD (3)

A

Cyanosis @ birth
HF @ 2-3 w
No murmurs

65
Q

What syndrome is complete AVSD associated with?

66
Q

Mx AVSD

A

Tx HF medically

Surgery @ 3-6m

67
Q

What is the most common cyanotic heart disease?

68
Q

4 components of ToF (VOSH)

A

VSD
Overriding of aorta
Subpulmonary stenosis
RV hypertrophy

69
Q

S+S ToF (3)

A

Severe cyanosis
Clubbing
Ejection systolic murmur L sternal edge from day 1

70
Q

Ix ToF (4)

A

AN USS (picked up)
CXR
ECG
Echo

71
Q

Mx ToF - initial

A

PG E2 infusion

Surgery to fit shunt

72
Q

Mx TOF >4months

A

Definitive surgery

73
Q

How should hypercyanotic spells in ToF be managed? (>15mins) (4)

A

Morphine
IV propranolol
IV volume admin
Bicarbonate

74
Q

What is TGA

A

Aorta connected to RV

Pulmonary aa connected to LV

75
Q

When does TGA usually present?

A

2nd day of life

76
Q

Mx TGA (3)

A

Maintain patency of DA
PG
Balloon Atrial septostomy (acute)
Arterial swtich procedure

77
Q

When does CoA present?

78
Q

Signs CoA (5)

A 
Sick baby 
Heart failure 
Murmur 
Absent femoral/R-F delay 
Metabolic acidosis
79
Q

Ix CoA (2)

A

ECG

CXR - cardiomegaly

80
Q

Syndromes causing CoA (4)

A

Turners
Marfans
NFM
Bicuspid AV

81
Q

Surgical Mx CoA

A

Surgical repair

Balloon angioplasty to buy time

82
Q

What are the common duct dependent lesions? (5)

A 
CoA
TGA
HLHS
Pulmonary atresia 
Triscupid atresia
83
Q

What is the most common cause of SVT?

A

Re-entry within the AVN

84
Q

Features SVT (4)

A

HR between 25-300
Sx HF
Hydrops fetalis/intrauterine death
Re-entry tachycardia

85
Q

ECG features SVT

A

Narrow complex tachyC

If heart failure –> T wave inversion

86
Q

Mx SVT

A

Circulatory/resp support
Vagal stimulating manouvers
IV adenosine
ECV

87
Q

Vagal stimulating manouvres for SVT (2)

A

Carotid sinus massage

Cold ice pack to face

88
Q

Which cardiac disorders is Noonans associated with? (4)

A

PS
Hypertrophic cardiomyopathy
ASD
VSD

89
Q

How does Marfan’s affect the heart?

A

Walls of aorta weakened –> aneurysms/dissection

Mitral/tricuspid valves prolapse

90
Q

Symptoms Kawasakis (7)

A 
Fever > 5 days 
Non-purulent conjunctivitis 
Red mucous membranes 
Cervical lymphadenopathy 
Rash 
Red palms/soles
Peeling fingers/toes
91
Q

Mx Kawasakis (3)

A

IV Immunoglobulin
Aspirin
Steroids

92
Q

Which genetic syndrome is associated with Aortic stenosis

93
Q

PS Aortic stenosis (4)

A

Cool peripheries
Mottled skin
Incr RR
Globally reduced pulses

94
Q

Murmur Aortic stenosis

A

Ejection murmur

95
Q

Which genetic syndrome is Pulmonary stenosis associated with?

96
Q

PS Pulmonary stenosis (3)

A

Pink baby
Ejection systolic murmur
Usually asymp

97
Q

What is the most common cardiac defect in Turners

CP2 PAEDS (18 decks)

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