CHD Flashcards
Side effects of indomethecin
Decreased renal function Hyponatremia Hyperkalemia Hypoglycemia Plt dysfunction/ thrombocytopenia GI bleed/NEC High BP
Side effects of PGE
Fever Apnea Flushing Hypotension Tachy or bradycardia Seizures
Right aortic arch
Echo
Angio
How do you manage severe PS?
PGE
Valvuloplasty
What cardiac lesions are associated with noonan syndrome?
Pulmonary stenosis
HOCM
ASD
Reasons for hypoxia post valvuloplasty?
RV hypertrophied
Inadequate valvuloplasty
Rv systolic dysfunction
Tricuspid regurg
what cardiac lesion are associated with phenytoin use?
ASD
VSD
TOF
what CH lesion is associate with Lithium use?
ebstein’s anomaly-displacement of the tricuspid valve towards the apex of the right ventricle
what is the most common cyanotic heart lesion
TOF
what can give you a wide pulse pressure
PDA
truncus arteriosus
aortic insufficiency
intravascular volume depletion
what can give you a narrow pulse pressure
pericardial tamponade
aortic stenosis
heart failure
how do you calculate the pulse pressure
sBP - dBP = Normal if less than 50
or
1/2 sBP whichever is less
what cardiac manifestation would you expect in
- TS
- NF
- Cardiac rhabdomyoma
2. pulmonary stenosis and CoA
what cardiac manifestation would you expect with Marfan Syndrome
aortic and mitral insufficiency - aortic regur, mitral prolapse
aortic root dilation
dissection
cardiac lesion for Digeorge
conotruncal - TOF, PA, TA, TGA
aortic arch anomalies
Cardiac lesion for VACTERL
VSD
Cardiac lesion for CHARGE
TOF
aortic arch
conotruncal issues
Cardiac lesion for congenital rubella
PDA
periph pulm stenosis
mitral regurg
Cardiac lesion for Turner’s
CoA
Cardiac lesion in Williams
supravalvular aortic stenosis
periph pulmonary artery stenosis
Which trisomy will have VSD, ASD, PDA and possible dextrocardia?
T13
what is an S4 associated with
found in late diastole
always abnormal
implies decreased ventricular compliance
what can give you a mid-systolic click
MVP
lesion sounds louder post valsalva
what lesions can give and ejection click
AS
PS
what are causes of continuous murmur?
PDA
venous hum
CoA with collaterals
Still’s M
- Vibratory
- LLSB
- Grade I-III
- Decreases in upricght
- Age - 3-7
Venous Hum M
- Continuous M
- infraclavicular
- Worse if standing
- Change intensity wit neck move
- I-III
- 3-6 yrs
boot shaped heart?
TOF
peripheral pulmonary stenosis features
- newborn to 6 mo
- axilla and back/LUSB
- low pitch
- grade 1-2
egg on a string
TGA
Snowman
TAPVR
what are the features of TOF
PROVe Pulmonary stenosis RVH Overriding aorta VSD
what types of shunting will give you increased pulm vascularity on CXR?
TGA
Truncus
TAPVR
(VSD ASD PDA PS Coarctation Left to Right)
TET spell mgnt
- knees to chest
- O2
- Fluid - 10cc/kg
- Morphine - 0.1 mg -
- Propranolol - dec HR and contractility
- Phenylephrine - alpha agonist - inc SVR
- Bicarb to correct acidosis
- I+V and sedation
what is the MC lesion to present in the newborn?
TGA
what shunt will give DECREASED pulm vasc on CXR?
TOF
tricuspid atresia
Ebstein
usually right to left shunts
neonate with cyanosis and resp distress?
TGA
If you find low pre-ductal sats and high post ductal sats, what lesion could this be?
TGA
How do you manage TGA initially
- PGE
- Keep stats > 60%
- If not enough - Balloon atrial septostomy
- Atrial switch and coronary re-implantation between 2-4 week. Can be later if have VSD
which cyanotic lesions tends to present without a murmur?
TGA
Tricuspic Atresia
TAPVR
what lesions need a PDA or VSD or ASD to survive
TGA
TA
what lesions needs 2 septal defects for survival?
Tricuspid atresia
ASD - R to L
VSD - L to right
what are the 2 types of complete vascular rings?
- double aortic arch
- right aortic arch with persistent ligamentum arteriosum
both have right sided aortic arch wich can help with Dx
what CHD with present at a few hours of life with cyanosis but no resp distress?
RIGHT HEART OBSTRUCTION TOF pulmonary atresia ebsteins Tricuspid atresia
what lesions will give you increased pulmonary markings
VSD ASD PDA \+/-PS TGA truncus TAPVR HLHS
what lesions can be heard from the back?
pulmonary stenosis
PDA
coarctation
what sats are expected post BT shunt and post Norwood
75-85%
who gets a Norwood?
Left hypoplastic heart syndrome
who gets a BT shunt
lesions with inadequate pulmonary blood flow
who gets pulmonary artery band?
for single ventricles
what are the expected sats post Fontan?
> 90%
what are cyanotic congenital heart disease. 6 T’s and 2 As
TGA TOF truncus arteriosus tricuspid atresia TAPVC Tingle ventricle
pulm Atresia
Ebsteins Anomaly
what CHD will have higher sats in left toe than right arm?
TGA
What CHD will have LVH?
Pulmonary atresia tricuspid atresia VSD AS Coartation
what CHD will have RVH?
TOF
TGA
TAPVR
hypoplastic L
ASD
PS
VSD if mode to large
what are 4 resp causes for neonatal cyanosis?
MAS PPHN pneumothorax pneumonia CDH
what cyanotic heart lesion has BL hypertrophy
truncus arteriosus
infant of DM, what are the cardiac lesions
D TGA
VSD
AS
what lesions are associated with right aortic arch
TOF
Truncus
single ventricle
what lesions will cause CHF at 6 weeks
VSF
AV canal
PDA
Coarctation
how to distinguish SVT
sudden onset and termination HR. 180 no variability in HR Fixed RR abnormal or no P waves
what are 2 SVT mechanisms
WPW
AV nodal re-entry
what are causes of a wide QRS
VT
myocarditis
cardiomyopathy
PVC
