Cardiology Flashcards
Differential Cyanosis
post-ductal; cyanosis of lower extremities (toes)
ex: aortic arch obstruction, R->L shunt
Reverse Differential Cyanosis
Pre-ductal, cyanosis of fingers
TGA
S4 in children, differential
AS, HOCM, MR
TR associated with
Ebstein Anomaly
Peripheral Pulmonary Stenosis
increase in blood flow to lungs via pulmonary artery
SEM, back and axilla
Venous Hum
blood draining from collapsed jugular veins into dilated intrathoraic veins
low pitched murmur, absent when supine
Innocent Murmur and position
increase when supine (increase in stroke volume)
softer w/ Valsalva
Aschoff Bodies
giant cells seen in heart associated with RF
ARF - 5 Jones Criteria
polyarthirtis carditis chorea subq nodules erythema marginatum
Carditis associated with ARF
Mirtral regurg
Myocarditis
Pericarditis
Erythema Marginatum appearance
serpiginous
Chronic treatment of ART
PCN for minimum of 5 years or until age 21
Most common cardiomyopathy in children
dilated
ASD - Ostium Secondum
Most Common
Fixed Splitting + RVOT
RVOT across pulmonic valve = SEM, best heard at LUSB
EKG associated w/ ASD
RAD, RVH
except, primum = LAD
ASD - Ostium Primum
partial AV canal defect, MR and TR
LVH on EKG =
tall R + negative T wave in V6
Anomalous Origin of Left Coronary Artery from Aorta
chest pain w/ exercise or SCD
when aorta dilates during exercise, cuts off blood supply to coronaries
Most common cause of cyanosis in first days of life =
TGA
d-TGA anatomy
pulmary artery connected to LV
Aorta connected to RV
need some type of connectin (PFO, PDA, VSD)
TGA CXR will show
egg or oval shaped heart
dTGA treatment
PGE1
balloon atrial septostomy to create AsD for mixing
additionally needs arterial switch surgery
Most Common Symptomatic Aortic Arch Abnormality
double aortic arch
Double Aortic Arch
encircling of the trachea and esophagus
will cause tracheal compression and resp compromise
associated with DiGeorge Syndrome
Diving Seal Reflex
place an ice bag on infant’s face for 10-20 seconds
Romano-Ward Syndrome
AD QT prolongation
Jervell and Lange-Nielseln Syndrome
AR QT prolongation
+ sensoneurial hearing loss
Ebstein Anomaly
septal leaflets of tricupsid valve are displaced downward
huge heart/RA
Ebstein Anomaly associations
maternal lithium use
Severe Pulmonary Stenosis
will present as severe cyanosis requiring PGE1
presents similar to pulmonary valve atresia, requiring PDA for flow
Mild-Moderate Pulmonary Stenosis Murmur
systolic ejection click + systolic C-D murmur
VSD murmur
harsh, holosytolic, loudest at LLSB (similar to MR)
PDA murmur
systolic/continuous murmur over left precordium
PDA is
fetal connection between aorta and pulmonary artery
Tricuspid Atresia presents as
cyanosis hours to days after birth
L superior axis deviation and LVH are present
Tetraology of Fallot components
VSD
Overriding aorta
RVOT
RVH
Treatment of Tet Spells
increase SVR or decrease PVR calm the child (decrease PVR) knees to chest (increase SVR) oxygen beta block morphine
Surgery or TOF
VSD patch closture
relief of PS/RVOT with transannular patch
TOF genetic syndrome associations
DiGeorge, Down Syndrome, trisomy 13, 18, Alagille, CHARGE
MVP
mid-late systolic murmur, louder with standing
Aberrant Right Subclavian Artery
most common aortic arch anomaly
rarely causes symptoms
Snowman or Figure 8 on imaging
total anomalous pulmonary venous return
pulmonary veins drain into the SVC
Cardiac association with Williams Syndrome
supravalvular aortic stenosis
Hypoplastic Heart Syndrome, correction
Norwood, Gleen, Fontan
Hypoplastic Left Heart Syndrome abnormalities
underdeveloped LV
underdeveloped aorta
PDA dependent
ASD
Side effect of procainamide
drug induced SLE
Rs pattern
normal in infants due to right ventricular predominance
Cardiac Rhabdomyomas associated with
Tuberous Sclerosis
CHD associated with fetal alcohol syndrome
septal defects, i.e. .VSD
Mechanism for SVT in neonates
AV re-entry
