Cardiovascular Flashcards
What occurs during S1?
Mitral and tricuspid valves close
Aortic and pulmonic valves open
What heart sound is associated with S1?
“Lub”
What occurs during S2?
Aortic and pulmonic valves close
Mitral and tricuspid valves open
What heart sound is associated with S2?
“Dub”
What period is systole?
between S1 and S2
What period is diastole?
between S2 and S1
What heart sound is described as “Ken-tuck’-y”?
S3
What heart sound is described as “Ten-ne-ssee’”?
S4
What heart sound would you expect to hear with a stiff ventricular wall (i.e. MI, left ventricular hypertrophy, chronic HTN)?
S4 “TEN-NE-SSEE’”
When would you expect to hear S3?
With increased fluid states, such as CHF or pregnancy
Where is the aortic valve heard?
Right upper sternal border (RUSB)
Where is the pulmonic valve heard?
Left upper sternal border (LUSB)
Where is Erb’s point found?
At the apex
Where is ventricular septal defects or tricuspid valve heard?
Left lower sternal border (LLSB)
Blood flows from ___ to ___ pressure.
High to low
If a diastolic murmur is heard, this always points to something _________.
Pathological
What scale is used to diagnose murmurs?
I to VI
This congenital heart defect comprises 30% of all congenital heart defects
VSD
Acyanotic lesions have what type of shunting?
Left to right
Cyanotic lesions have what type of shunting?
Right to left
ASD is what type of defect?
Acyanotic (L to R shunting)
Where is the ASD best heard?
Left upper sternal border
When a thrill is present, this typically describes what type of defect?
VSD
Where is the VSD best heard?
Left lower sternal border
VSD is what type of defect? (Acyanotic vs. Cyanotic)
Acyanotic
Patent ductus arteriosus (PDA) is what type of defect?
Acyanotic
Where is the PDA best heard?
Left upper sternal border
What does the PDA sound like?
“machinery” sound
A machinery sound murmur, typical of a PDA, is what type of murmur?
Holosystolic
Transposition of the Great Arteries is what type of defect?
Cyanotic
With TGA, the murmur is similar to that of what other type of defect?
VSD
What does the Xray show of a patient with TGA?
“Egg on a string” with cardiomegaly and increased pulmonary vascular markings
TET is what type of defect?
Cyanotic
What are the four defects associated with TET?
Large VSD
Pulmonary Stenosis
Overriding Aorta
Right Ventricular Hypertrophy
What does the murmur sound like in TET and where is it best heard?
Loud systolic ejection click at the middle and upper left sternal border
What does the heart look like in TET as seen on XR?
Boot-shaped
What is a TET spell and how can you correct this?
It is a hypercyanotic spell and is corrected by placing the patient in a knees to chest position
Aortic stenosis is what type of defect?
Cyanotic
Aortic stenosis has a systolic ____ where? There may also be a systolic ejection click that does not vary with _____.
Thrill
Respiration
Pulmonic stenosis is heard loudest where?
Left upper sternal border
Unlike aortic stenosis, pulmonic stenosis ______ with inspiration and ______ with expiration.
Decreases with inspiration
Increases with expiration
Coarctation of the aorta is what type of defect?
Cyanotic
With coarc, there is a systolic ejection murmur with radiation where?
Left interscapular area
The blood pressure in the lower extremities is _____ compared to the upper extremities in Coarctation of the Aorta.
Decreased
X-ray findings can show ___ _______ due to collateral circulation
Rib notching
What are three common signs/symptoms of a child with cardiac defects?
Frequent respiratory infections, feeding problems, clubbing
Also: diaphoresis
Functional, benign, or physiologic murmurs are examples of what types of murmurs?
Innocent Murmurs
Innocent murmurs occurs in more than __% of children
50%
True or False: innocent murmurs may vary with position
True
What is the most common innocent murmur?
Still’s murmur
What causes the Still’s murmur?
Turbulence in the left ventricular outflow tract
How is a Still’s murmur described?
Musical systolic murmur
A venous hum can be heard where? What position is it heard best in? Does it change with movement?
Continuous humming murmur in the Right upper sternal border, heard best in the sitting position and disappears in the supine position
A persistent elevation of average systolic/diastolic blood pressure > 95th percentile with measurements obtained on at least three separate occasions.
Hypertension
A post-infectious inflammatory disease that can affect the heart, joints, and central nervous system.
Rheumatic Fever
Rheumatic fever follows that type of infection? What valve is most affected?
Group A strep
Mitral valve
Diagnosis of an initial attack of rheumatic fever must contain __ major OR ___ major and __ minor Jone’s criteria.
Two major
1 major, 2 minor
What diagnostic test would you anticipate ordering for rheumatic fever?
ECG, Echocardiogram
Patients with rheumatic fever may require ______ ______ for invasive procedures.
Prophylactic antibiotics
Acute febrile syndrome causing vasculitis and is the leading cause of coronary artery disease in children of an infectious etiology under the age of TWO.
Kawasaki disease
The patient must have a fever for how many days for Kawasaki. They must also have ___ other symptoms associated with the disease.
5 days
4
What are the other criteria for Kawasaki? (CRASH)
Conjuctivae injected without exudate Rash (polymorphic) Adenopathy (cervical lymphadenopathy) Strawberry (hyperemic lips, strawberry tongue) Hands (Erythema/dysquamation)
What is given to provide immediate vasodilation with Kawasaki disease?
Aspirin
