CARDS Flashcards
Tricuspid valve atresia is a cyanotic congenital heart defect characterized by absent communication between the right heart chambers. Findings include tall P waves (right atrial enlargement) and left axis deviation (left-sided volume overload) on ECG and decreased pulmonary markings on chest x-ray (hypoplasia of right ventricle and pulmonary outflow tract).
Dusky infant with II/VI holosystolic murmur loudest at left lower sternal border, chest radiogram demonstrates decreased pulmonary vascular markings and flatted right border
Tricuspid atresia
Tricuspid valve atresia is a cyanotic congenital heart defect characterized by absent communication between the right heart chambers. Findings include tall P waves (right atrial enlargement) and left axis deviation (left-sided volume overload) on ECG and decreased pulmonary markings on chest x-ray (hypoplasia of right ventricle and pulmonary outflow tract).
How does a VSD lead to heart failure?
A ventricular septal defect creates a holosystolic murmur best heard at the left midsternal border. A large VSD allows substantial left-to-right shunting that leads to pulmonary overcirculation and left-sided volume overload, eventually leading to heart failure.
VSD
If the following defect is not corrected within 10 years, what may develop?
Eisenmenger
What leads to mitral stenosis in kiddos?
Its RARELY congenital
Mitral stenosis most commonly results from rheumatic fever and is rarely present congenitally.
Pulse oximetry readings are 90% in the right hand and 79% in the right foot on 100% oxygen. Physical examination is remarkable for meconium-stained nails and intercostal and subxiphoid retractions. Chest x-ray reveals bilateral, patchy opacities and hyperinflation consistent with meconium aspiration syndrome. Echocardiogram shows decreased right ventricular output.
Persistent pulmonary hypertension of the newborn (PPHN)
What does standing or valsalva do to HCM?
Maneuvers that decrease LV blood volume (eg, the reduced venous return that occurs with Valsalva strain phase or standing from a supine position) decrease LV size; this worsens the LVOT obstruction and increases the intensity of the murmur. This contrasts with the murmur of aortic stenosis, which increases in intensity with increased ventricular preload.
How can gestational diabetes lead to HCM?
↑ Glycogen & fat deposition in interventricular septum → dynamic LVOT obstruction
Why does squatting help in tet spells?
Squatting may reduce symptoms (eg, cyanosis) and increases the intensity of the systolic murmur. This maneuver increases the systemic vascular resistance (afterload) and decreases the right-to-left shunting across the ventricular septal defect, which thereby increases flow across the RVOT.
What are the major causes of viral myocarditis in kiddos?
Cocksakie B and adenovirus
abnormal persistence of elevated pulmonary vascular resistance, causing right-to-left shunting across a patent ductus arteriosus. Patients have a low postductal saturation compared to the preductal saturation and normal distal pulses.
Persistent pulmonary hypertension of the newborn
How will transposition of the great vessels tend to present?
Transposition of the great vessels is a congenital cyanotic heart defect that typically presents within the first 24 hours of life with cyanosis and a single loud S2.
Most common congenital defect in downs
Complete atrioventricular septal defect is the most common heart defect in Down syndrome. Clinical features can include heart failure in early infancy, a fixed split S2, and a systolic ejection murmur due to increased pulmonary flow from the atrial septal defect.
A 3 year od child presents with 6 day hx of fever with conjunctivits and strawberry tongue. What is a CANNOT MISS diagnosis?
Kawasaki disease which is characterized by ≥5 days of fever and ≥4 of the following: nonexudative conjunctivitis, mucositis (eg, strawberry tongue), rash, extremity changes, and cervical lymphadenopathy. Echocardiogram is indicated for all patients to assess for coronary artery aneurysms.
Strawberry tongue:
A bright red tongue with papillary hyperplasia that may be present in patients with scarlet fever, Kawasaki disease, or food/drug allergies.
