Cardiovascular Issues and Disorders Flashcards
What heart sound is heard when the mitral/tricuspid (AV) valves close?
S1
What heart sound is heard when the aortic/pulmonic (semilunar) valves close?
S2
What is the period between S1 and S2?
systole
What is the period between S2 and S1?
diastole
What heart sound can be heard during periods of increased fluid state, such as with CHF and pregnancy?
S3
What heart sound is described as sounding like “Ken-tuck-y?”
S3
What heart sound can be heard when ventricle walls are stiff, such as with an MI, left ventricular hypertrophy, or chronic hypertension?
S4
What heart sound is described as sounding like “Ten-ne-ssee?”
S4
What are you listening to when auscultating in the right upper sternal border?
aortic
What are you listening to when auscultating in the left upper sternal border?
pulmonic
What are you listening to at Erb’s point (apex)?
aortic or mitral
What kind of defect would you hear at the left lower sternal border?
VSD or tricuspid
Blood flows from areas of _____ to _____ pressure.
higher to lower
What does a VSD sound like?
thrill
What defects represnt left to right shunting?
acyanotic lesions
What defects represent right to left shunting?
cyanotic lesions
ASD, VSD, and PDA are considered what kind of defects?
acyanotic defects
Transposition of the great arteries and tetralogy of fallot are considered what kind of defects?
cyanotic defects
Aortic stenosis, pulmonic stenosis, and coarctation of the aorta are considered what kind of defects?
obstructive defects
What is the most common congenital heart defect?
VSD
With what heart defect is a fixed split S2 a common finding?
ASD
What kind of murmur would you hear at the LUSB when an ASD is present?
systolic ejection murmur
With what defect would you hear/feel a holosystic thrill at the LLSB?
VSD
When would you hear a holosystolic thrill with a VSD?
throughout systole
What kind of defect produces a “machinery” sounding holosystolic murmur heard best at the LUSB?
PDA
What cyanotic heart defect has the same murmur as with a VSD?
transposition of the great arteries
What heart defect is described as “egg on a string” with x-ray?
transposition of the great arteries
What are the 4 defects associated with a tet?
large VSD, pulmonary stenosis, overriding aorta, and right ventricular hypertrophy
With what heart defect is the murmur described as a loud systolic ejection click at the middle and upper left sternal border?
tetralogy of fallot
How is a tet spell described?
hypercyanotic episode
With what heart defect is the murmur described as a systolic thrill at the RUSB and systolic ejection click which does not vary with respirations?
aortic stenosis
With what heart defect is the murmur described as a thrill at the LUSB radiating to the back and sides and does the intensity of the murmur decrease with inspiration and increase with expiration?
pulmonic stenosis
What is the cardinal finding associated with coarctation of the aorta?
decreased or absent pulses in the lower extremities, as well as BP lower in the lower extremities than the upper
What kind of murmur is heard with coarctation of the aorta?
aortic/ejection click with radiation to the left inter scapular area
What kind of heart defect(s) is associated with DiGeorge syndrome?
aortic arch anomalies
What kind of heart defect(s) is associated with down syndrome?
atrioventricular septal defects, VSD
What kind of heart defect(s) is associated with marfan syndrome?
aortic regurgitation, mitral valve prolapse
What kind of heart defect(s) is associated with turner syndrome?
coarctation of the aorta, bicuspid aortic valve
What kind of murmur is described as a low intensity systolic murmur that can vary with position (sitting > standing)?
innocent murmur (i.e. functional, benign, or physiologic murmur)
What can be best described as when the heart rate varies upon inspiration and expiration?
sinus arrhythmia
What is the most common innocent murmur in children?
still’s murmur
How is a still’s murmur described?
musical systolic murmur heard best between LLSB and apex
Where can a venous hum be heard best?
RUSB
What murmur is heard best in the sitting position and disappears in the supine position?
venous hum
What murmur is obliterated by turning head and/or compressing neck ipsilaterally?
venous hum
What is a persitent elevation of average systolic/diastolic blood pressure >95th percentile with measurements obtained on at least three separate occasions per published tables for age and sex?
hypertension
What is a post-infectious inflammatory disease that can affect the heart, joints, and central nervous system?
rheumatic fever/heart disease
What kind of infection does rheumatic fever follow?
group A strep infection
How is rheumatic fever diagnosed?
two major or one major and two minor Jones’ criteria
What is an acute febrile syndrome causing vasculitis and most commonly noted in children under the age of 2?
Kawasaki disease
What is the leading cause of coronary artery disease in children of an infectious etiology?
Kawasaki disease
What ECG changes would be seen with Kawasaki disease?
prolonged PR or QT interval
When diagnosing Kawasaki disease, the patient must have fever > 5 days and at least 4 other symptoms. When remembering the symptoms, what pneumonic can be used and what does it stand for?
“Fiery CRASH” (think 5 days of fever and 5 letters in fiery); C - conjunctival injection, R - polymorphous rash, A - cervical lymphadenopathy, S - strawberry tongue, H - erythema and edema of hands
How would a pediatric cardiologist treat Kawasaki disease?
high-dose aspirin, 80-100mg/kg/day until afebrile for 48 hours, then lower dose to 3-5mg/kg/day
