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CARDIOVASCULAR Flashcards

1
Q

What is the etiology of Atrial Septum Defect (ASD)?

A

osteum secundum

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2
Q

What is the definition of ASD?

A

hole in the ATRIAL septum

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3
Q

What are the S/S of ASD?

A

most patients are asymptommatic until > 30 years old

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4
Q

What type of murmur is ASD?

A

systolic ejection crescendo-decrescendo murmur at the PULMONIC area

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5
Q

What type of split does ASD have?

A

WIDELY SPLIT S2 that does NOT vary with respirations (splits all throughout respirations)

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6
Q

What would see on the EKG for a patient that has ASD?

A

incomplete or complete RBB - present in ALL ASD patients

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7
Q

What is the treatment for ASYMPTOMATIC patients with ASD?

A

no treatment needed. Shunts will likely close on their own and require nO intervention

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8
Q

What is the treatment for SYMPTOMATIC patients with ASD?

A

shunts > 1:5:1 - percutaneous device or surgery

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9
Q

What is the definition of Ventricular Septum Defect (VSD)?

A

hole in the ventricular septum

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10
Q

What is the most common type of VSD?

A

membranous

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11
Q

What type of murmur do SMALL shunts cause in VSD?

A

HIGH PITCHED, HARSH HOLOSYSTOLIC murmurs

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12
Q

Where is the murmur best heard at in VSD?

A

3rd or 4th intercostal spaces along the LEFT sternal border

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13
Q

What is Eisenmenger Syndrome?

A

occurs when a left to right shunt switches to a RIGHT to LEFT hunt

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14
Q

What are the S/S of Eisenmenger Syndrome?

A

cyanosis, dyspnea, syncope, desaturation, clubbing

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15
Q

What is the diagnostic test of choice for ALL pediatric murmurs?

A

ECHO

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16
Q

Treatment for VSD?

A

observation as most are asymptomatic

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17
Q

Treatment when VSD is residual from a prior patch closure, pulmonary HTN or cyanosis?

A

antibiotic prophylaxisis

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18
Q

treatment for large shunts of VSD?

A

patch closure surgery

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19
Q

What is Patent Ductus Arteriosus (PDA)?

A

persistent aortic-pulomonary shunt via ductus arteriosus that fails to completely close at birth

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20
Q

What is the etiology of PDA?

A

HIGH PGE E2 production and LOW oxygen promote patency (keeps ductus OPEN!)

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21
Q

Most kids with PDA are ___________

A

asymptommatic

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22
Q

What symptoms will develop in kids with PDA?

A

poor feeding, poor weight gain, weight loss

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23
Q

What kind of murmur is in a patient with PDA?

A

Machine like murmur that is loudest in the PULMONIC area. May radiate to the back

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24
Q

What type of pressure is in patients with PDA?

A

WIDE bounding pulse pressure (> 30 mmHg) including BOUNDING peripheral pulses

LOUD S2 sounds

25
What is the treatment for PDA?
FIRST LINE: IV Indomethacin or Ibuprofen (NSAIDS)
26
What is the most common form of cyanotic heart disease in a newborn?
Transposition of the great vessels
27
Failure of the _____ to increase suggest cyanotic heart disease
PaO2
28
What would you see on a physical exam of a patient with TofGV?
Systolic murmur and a single S2 sound
29
What is coarctation of the aorta?
Congenital nearing of the aortic looming at the distal, arch or descending or aorta
30
What does CoA cause?
Systolic hypertension in the upper extremities relative to the lower extremities (blood pressure is higher in the arms than it is the legs)
31
CoA is associated with what syndrome?
Turner’s syndrome
32
What heart valve is CoA associated with?
Bicuspid valve
33
What is the most symptom of CoA?
Hypertension (MC in adults)
34
What type of pulses does CoA have?
STRONG arterial pulses that are seen in the neck and super sternal notch
35
Describe the type of murmur in CoA?
Harsh systolic murmur along the left sternal border radiating to the back, left in scapular region, or chest
36
What are some physical exam findings in a patient with CoA?
Systolic hypertension is higher in arms > legs (> 10 mmHg)
37
How are the femoral pulses affected in CoA?
For more pulsations are weak and delayed in comparison with the brachial and radial pulse
38
What does the EKG show in a patient with CoA?
LVH
39
What is a Hallmark finding in the chest ray for a patient with CoA?
Posterior rib notching Figure 3 sign
40
What is a confirmatory test for CoA?
ECHO
41
What is the treatment of choice for a patient with CoA?
Endovascular stenting (balloon preferred over metal)
42
What conditions are associated with Tetralogy of Fallot ?
Down syndrome DeGeorge’s syndrome
43
Is tetralogy of fallot cyanotic or acyanotic
Cyanotic (right to left shunt)
44
What are the four parts that make up the etiology of TofF?
Overarching aorta VSD Pulmonary stenosis Right ventricular hypertrophy
45
TofF is also known as what?
Blue baby syndrome Blue spells and issue the first two years of life this consist of restlessness, cyanosis, gasping, respirations, and syncope
46
What is the treatment for? TofF?
Surgical repair in the first 3 to 12 months of life And patients TOF, a TTE is recommended every 12 to 14 months based on his degree of regurgitation
47
What type of murmur is TofF?
Harsh holosystolic murmur at the left upper sternal border
48
What type of murmur is TofF?
Harsh holosystolic murmur at the left upper sternal border
49
What EKG findings would you see on a patient with TofF?
RVH
50
What would you see on a chest rate in a patient with TofF?
“Boot shaped” with the prominence of right ventricular and a cavity in the right ventricular outflow tract
51
What is the second most common CYANOTIC congenital heart disease?
Transposition of the Great Arteries (TOGA)
52
Where does the majority of mixing in the Transposition of the Great Arteries?
at the atrial level
53
If the atrial communication is inadequate at birth in TGV then a patient can becomes severely ________
cyanotic
54
What are the signs and symptoms of TOGA?
many newborns are profoundly cyanotic newborn **WITHOUT** distress or a significant murmur MC in males
55
Imaging on TOGA
CXR: show **egg on a string apprance**
56
In TOGA, there is + involution but no ______
twisiting (hence arteries are **PARALLEL**
57
**INITIAL** treatment of TOGA
**Prostalglandin E1 (Alprostadil)** to maintain PDA
58
**DEFINITIVE** treatment for TOGA
Arterial Switch Operation (ASO)

PEDIATRICS (8 decks)

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