Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

MBBS3-Pediatrics > Common cardiac diseases > Flashcards

Common cardiac diseases Flashcards

1
Q

what are some congenital structural lesions of the heart

A

septal defects (hole in the heart)- ASD, VSD, at the endocardial cushions

vessel abnormalities- transposition of the great vessels, coarctation of the aorta, pulmonary stenosis, PDA

valve abnormalities- tricuspid atresia, aortic stenosis

major structural abnormalities- fallot’s tetralogy, hypoplastic left heart

failure to transition- PDA, persistent fetal circulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are cyanotic congenital heart diseases

A

-transposition of the great arteries
-tetralogy of fallot
-critical pulmonary stenosis
-other complex structural defects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

whats a duct dependent heart disease

A

its when the heart has structural abnormalities which are incompatible with life outside the womb once the ductus arteriosus closes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what can accelerate the closure of the ductus arteriosus

A

oxygen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what are the components of TOF

A

-pulmonary stenosis
-right ventricular hypertrophy
-perimembranous VSD
-overriding aorta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

when does TOF present

A

infancy/ early childhood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

how does a child with TOF look like from early life

A

dusky, gradually increasing over time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are some physical signs of TOF

A

-persistent cyanosis
-ejection systolic murmur which corresponds to pulmonary stenosis
-hyper cyanotic spells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what happens to the blood cells of a child with TOF

A

polycythemia occurs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

for TOF what does the CXR show

A

a boot shaped heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

how do you diagnose TOF

A

echocardiogram

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

whats the treatment for TOF

A

surgical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

whats the management for TOF

A

-antibiotic prophylaxis
-anticoagulation
-treating hyper-cyanotic spells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what causes the hyper cyanotic spells to occur

A

right ventricular outflow obstruction, which gets worse over time and acute episodes of pulmonary infundibular spasm occur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what precipitates the hyper-cyanotic spells and how long do they last

A

activity like feeding/ playing and can last minutes and then resolve or progress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

how do the hypercyanotic spells present

A

-deepening cyanosis
-agitation
-tachypnea
-pallor
-floppiness can occur
-loss of consciousness (where brain damage can occur)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

how do older children terminate hyper-cyanotic spells

A

by squatting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

how can you treat cyanotic spells

A

putting child in a squatting or knee to chest position- this increases systemic vascular resistance and promotes systemic venous return to the heart

giving oxygen- to decrease peripheral vasoconstriction (its a pulmonary vasodilator)

analgesia (e.g. morphine)- to decrease release of catecholamines hence decreasing HR, increasing filling time and relaxation of the infundibular spasm

i.v fluid bolus- to improve right ventricular preload

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what are congenital lesions which may cause heart failure

A

-VSD
-ASD
-PDA
-coarctation of the aorta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what is a VSD

A

its where there is a connection between the 2 ventricles causing left to right shunt

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

whats the commonest cause of heart failure in infancy

A

VSD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what do you hear from a VSD

A

harsh pansystolic murmur louder at the left lower sternal edge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

if the hole is big in VSD what is the murmur like

A

quiet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

why is there no murmur in VSD in the newborn period

A

because the high pulmonary vascular resistance results in minimal shunting across the defect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
how do you treat VSD
surgery
26
how do you manage VSD
-treat heart failure -antibiotic prophylaxis
27
what is ASD
its when theres a connection between the 2 atria, causing a left to right blood flow and an overloaded right side of the heart
28
in ASD how do the children present
they are asymptomatic
29
what do you hear in a child with ASD
an ejection systolic murmur loudest in the pulmonary area, caused by increase in blood flow through the pulmonary valve
30
what does a CXR for ASD show
-big heart -large pulmonary artery -pulmonary plethora -small aorta
31
how do you treat ASD
surgically
32
what is the medical management for ASD
-treat heart failure -antibiotic prophylaxis
33
where do you mainly see PDA
premature infants
34
how does PDA occur
when there is failure to close the ductus arteriosus
35
what happens in PDA
there is reversed flow from the aorta to the pulmonary circulation
36
what do you hear in PDA
machinery murmur below left clavicle
37
what is coarctation of the aorta
its when there is narrowing at a specific point in the aorta, usually before the point at which the ductus arteriosus
38
when does coarctation of the aorta present
when the duct closes, with collapsed baby and heart failure
39
what do you see in a child with coarctation of the aorta
-reduced or absent femoral pulses -systolic murmur
40
how do you treat coarctation of the aorta
surgically
41
how do you manage coarctation of the aorta
-treat heart failure -antibiotic prohylaxis
42
what are acquired causes of heart failure
-rheumatic heart disease -cardiomyopathy -myocarditis -bacterial endocarditis
43
what does rhematic heart disease cause
episode/episodes of acute rheumatic fever leading to endocardium inflammation
44
what does RHD mainly affect
mitral and aortic valves
45
how does inflammation in RHD settle
with scarring, fibrosis and deformity of the valve which may lead to heart failure over time
46
what happens in RHD-mitral regurgitation
during systole blood goes backwards through the incompetent valve from from the left ventricle to the left atrium and pulmonary veins
47
what does mitral regurgitation caused by RHD result in
-reduced cardiac output causing pulmonary edema -left ventricular hypertrophy to compensate
48
how does a patient with mitral regurgitation present
they are easily fatigued and breathless as heart failure develops (symptoms do take a long time to develop though)
49
what is cardiomyopathy
its weakened heart muscle commonly with dilation
50
what causes cardiomyopathy
-idiopathic -related to underlying metabolic or connective tissue disorders
51
whats myocarditis
inflammatory process of heart muscle following viral illness (coxackie B virus)
52
what is cardiomyopathy and myocarditis characterised by
poorly contracting large flabby heart with HF
53
what does cardiomyopathy and myocarditis present with
-heart failure -poor perfusion -mitral regurgitation murmur
54
where does bacterial endocarditis occur
in children with congenital or acquired heart defects
55
what does bacterial endocarditis cause
-turbulent blood flow across a valve -bacterial vegetations to form on damaged endothelium which shed infective emboli
56
bacterial endocarditis is a differential for a child with what cardiac signs
-janeway lesions -splinter hemorrhages -roth spots (these are from shed off infective emboli which block the microcirculation)
57
whats the usual onset of bacterial endocarditis
insidious with fever, fatigue, loss of appetite and joint pains but it can be acute with fever, prostration and HF
58
on examination what do you see with someone with bacterial endocarditis
-variable heart murmur -petechial rash -splinter hemorrhages -osler nodes -clubbing -subconjunctival hemorrhages -splenomegaly -neurolgy
59
why should you give antibiotics be given to children with heart lesions when they have any form of surgery/dental procedure as prophylaxis
to prevent infective endocarditis
60
how do you treat heart failure
- by reducing the amount of blood the heart has to pump - by making the heart pump harder - by supportive therapy
61
how do you reduce the amount of blood the heart has to pump to treat HF
1. with diuretics- frusemide and spironolactone (1-3mg/kg/day) 2. with vasodilators to reduce the amount of work e.g. captopril (N.B captopril can cause hypotension espec in pts with ventricular dysfunction so measure BP before introducing captopril.)
62
how do you make the heart pump harder to treat HF
1. digoxin (10-30ug/kg/day) 2. inotropes e.g. noradrenaline and adrenaline given on ICU/HDU
63
how does supportive therapy treat HF
1. feeding- tube feeding is helpful in babies if there are feeding difficulties and taking low salt in food 2. nursing- nurse in a sitting position
64
why would children with untreated VSD/ ASD eventually turn blue
this is because it will cause a chronic increase in pulmonary blood flow, which will cause irreversible damage to the pulmonary vasculature causing pulmonary damage. This then results in flow across the VSD/ASD to reverse causing the child to become cyanosed and polycythemia (N.B its now too late to fix the septal defect)

MBBS3-Pediatrics (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions