Cardiology Long

Question 1

What Qs do you have to ask about Cardiac Dx?

Answer 1

What diagnosis, When made, Where made, Symptoms @ diagnosis (e.g. cyanosis, inc RR, feeding, FTT, recurrent sepsis), How made (initial Ix e.g. XR, ECG, Echo, angiography)

Question 2

What Qs do you have to cover for Cardiac Presenting Complaint?

Answer 2

1) Diagnosis: When made, Where made, What made, Symptoms @ diagnosis → cyanosis, ↑ RR, feeding, FTT, recurrent sepsis; Initial Ix
2) Current state of disease: Now (symptoms, recent ECHO), change in condition over time
3) Complications in past of disease: IE, Polycythemia (headaches, visual problems, HT), Cerebral emboli
4) Treatment: Past and present (including side effects of treatment), Surgical (including any future plans for surgery)/ablations, Medical (including monitoring of drug levels and compliance with Rx), Antibiotic prophylaxis for dental procedures, Compliance with treatment
5) Follow-up: Where, when, How often

Question 3

What Qs do you have to cover for cardiac disease impact on child?

Answer 3

o On growth
o On development
o On psyche
o On ADLs
o On schooling (academic, sports, teacher and peer attitudes)

Question 4

Causes of Developmental Delay in Cardiac Primary Presenting complaint?

Answer 4

1) Genetic
2) chronic disease
3) prolonged periods of hospitalisation
4) adverse affect social development (overprotection)
* Management → provide stimulating environment and encouraging normal schooling

Question 5

Which cardiac patients need endocarditis prophylaxis?

Answer 5

1) Unrepaired cyanotic (including palliative shunts)
2) Repairs (completed) w prosthetic insertion (up to 6months after repair)
3) Repaired defects with residual defects
*Management: All kids should be given letter → show doctor or dentist pre-procedure

Question 6

What is the only contraindication to immunisations in a cardiac patient?

Answer 6

Immune deficiency (live vaccines) e.g. Di George

Question 7

Mx approach to exercise in cardiac pt?

Answer 7

o Let child set own limits
o May suggest avoid competitive sport if severe PHT, mod-severe AS, HOCM

Question 8

Which common cardiac drug is teratogenic?

Answer 8

Warfarin

Question 9

The OCP is contraindicated in what instances?

Answer 9

• Smoking
• Prosthetic heart valves
• Cyanotic heart disease
• PHT

Question 10

What is the genetic risk to siblings/children to also have cardiac disease?

Answer 10

• If one sibling with condition → 1-4%
• If one parent with condition → 2-4%

Question 11

What is the 5 year survival post Cardiac transplant?

Answer 11

50-80%