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Cardiology Flashcards

1
Q

Aortic stenosis murmur

A

Right upper sternal border
Midststolic ejection
Radiating to neck

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2
Q

Pulmonic stenosis murmur

A

Left upper sternal border

Softer P2

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3
Q

Atrial septal defect murmur

A

Wide, fixed, split S2
LUSB systolic ejection murmur
Short mid-diastolic murmur at LLSB

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4
Q

Williams syndrome heart

A

Supravalvular aortic stenosis

+/- branch PA stenosis

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5
Q

Murmur that increases with standing

A

Increase with standing or valsalva: HOCM or MVP

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6
Q

Delete this one

A

Delete this one

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7
Q

Long-term complications of an unrepaired ASD

A

Pulmonary hypertension
Atrial dysrhythmias
Tricuspid or mitral insufficiency
Heart failure

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8
Q

Abx prophylaxis indicated for endocarditis… (7)

A
  • Prosthetic cardiac valves
  • Previous infective endocarditis
  • Unrepaired cyanotic congenital heart disease, incluing palliative shutns and cnoduits
  • Completely repaired CHD with prosthetic material/device within first SIX MONTHS
  • Repaired CHD with RESIDUAL defects at the site ora djance to the site of prosthetic patch or prosthetic device (which inhibit endothelialization
  • Cardiac transplant recipients with cardiac valvulopathy
  • Rheumatic heart disease if prosthetic valves/material used in valve repair
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9
Q

CHD with increased pulmonary blood flow (6)

A 
Transposition of the great arteries
Total anomalous pulmonary venous return
Truncus arteriosus
Hypoplastic left heart syndrome
Single ventricle physiology
DORV (without PS)
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10
Q

Cyanotic heart disease with decreased pulmonary blood flow (5)

A 
Tetralogy of Fallot
Pulmonary atresia
Tricuspid atresia
Ebstein anomaly
Single ventricle with pulmonary stenosis
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11
Q

Marfan

- gene, genetics and features

A
  • fibrillin gene
  • AD inheritance
    signs: positive thumb, pectus excavatum, scoliosis, long arms, dilation of ascending aorta, mitral valve prolapse
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12
Q

Suprasternal notch thrill

A

aortic stenosis

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13
Q

SEM radiating to back

A

PS, PDA, coarctation

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14
Q

Cardiac syncope features

A
  • little or no prodrome
  • prolonged LOC (> 5min)
  • exericse or startle induced
  • associated chest pain or palpitations
  • hx of cardiac disease
  • positive fam hx
    +/- abN exam
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15
Q

fright/startle induced syncope

A

think long QT

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16
Q

1st line therapy for long QT syndrome

and normal QTc values

A
  • beta blockers
  • avoid QT prolonging drugs
    boys < 0.45, girls < 0.47
17
Q

Features of WPW on ECG

A
  • short PR interval

- delta wave

18
Q

Risks of WPW

A
  • SVT

- sudden cardiac death

19
Q

Torsades de pointes causes

A
  • long QT syndrome
  • hypomagnesemia
  • hypokalemia
20
Q

ECG shows left axis

A
  • think AVSD
  • small RV (e.g. tricuspid atresia)
  • Noonan syndrome
21
Q

Normal saturations based on operations:

  • Sano or BT shunt (Norwood)
  • arterial switch
  • Glenn
  • Fontan
A

Sano/BT shunt/Norwood: 75-85%
Art switch: 100% sats
Glenn: 75-85%
Fontan: >90 (usually)

22
Q

Fontans-specific complications

A
  • protein losing enteropathy

- plastic bronchitis

23
Q

Coronary artery involvement in KD (%)

A
  • ~20% untreated

- 5% with treatment

24
Q

5Ts and 3As of cyanotic congenital heart disease

A
  1. truncus
  2. transposition
  3. tricuspid atresia
  4. tetralogy
  5. total anomalous pulmonary venous connections
  6. Atresia pulmonary
  7. Anomaly Ebsteins
  8. A single ventricle
25
Q

Pericarditis ECG findings

A
  • depressed PR interval

- elevated ST

26
Q

Causes of CHF by age

  • 1st week of life
  • weeks 2-6
  • older children
A

1st week: obstructions e.g. HLHS, severe AS, coarctation, asphyxia, severe MR or TR, uncontrolled tachy e.g. SVT>24hr
Week 2-6: VSD, AVSD, PDA (not ASD)
Older children = pump failure: dilated CM, myocarditis, tachycardias

27
Q

3 cardinal signs of CHF in infants

A
  1. tachycardia
  2. tachypnea
  3. hepatomegaly
28
Q

Rheumatic fever diagnosis

A
  • 2 major
    or 1 major and 2 minor
  • AND evidence of recent GAS infection
    (different in low vs moderate/high-risk population)
29
Q

Rheumatic fever criteria major and minor

A

Major: carditis, polyarthritis, chorea, subcutaneous nodules, erythema marginatum
Minor: fever, polyarthalgia, prolonged PR, elevated CRP or ESR

30
Q

Cor pulmonale

symptoms

A

= right heart dysfunction secondary to pulmonary disease

features: SOBOE, decreased activity tolerance, CP, syncope on exertion, edema, decreased appetite/energy

31
Q

Pulmonary hypertension and cor pulmonale physical findings

A
  • precordial bulge
  • RV heave
  • single S2
  • TR, PR murmurs
  • pulsatile liver (TR)
  • hepatomegaly
  • edema
32
Q

ARF prophylaxis

A

ARF without carditis - 5 yrs or until 21 yrs
ARF with carditis (no valvular disease) - 10 yrs or until 21 yrs
ARF with carditis and persistent valvular disease - 10 yrs or until 40 yrs of age (sometimes lifelong)

33
Q

Treatment ARF

A
  • bed rest and monitor for carditis (ambulate when inflam has subsided)
  • 10 days of oral penicillin or a single IM pen (then long term prophylaxis)
  • ASA
  • steroids if carditis and significant heart involvement
34
Q

Long QT syndrome treatment

A
  • beta blockers
35
Q

TOF 4 features

A
  1. stenosis of pulmonary artery
  2. intraventricular communication
  3. over-riding aorta
  4. right ventricular hypertrophy
36
Q

Management of tet spells

A
  1. knee chest position
  2. oxygen
  3. IV fluid bolus
  4. IV morphine
  5. IV beta blocker
  6. IV phenylephrine
  7. emergency repair
37
Q

Prostaglandin side effects

A

apnea/hypoventilation

others: hypotension, flushing, hyperthermia

38
Q

HoCM screening

A
  • ECG and echo q3-5 yr for children < 12yo

- annually for 12+ yrs

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