Conditions Flashcards
What is the most common arrhythmia in children?
SVT = most common childhood arrhythmia
Signs and symptoms of SVT?
HR 250-300bpm -> poor CO, pulmonary oedema
Neonatal = HF, hydrops fetalis
Foetus = IUD
Investigations of SVT?
ECG – narrow complex tachycardia (delta wave in WPW), T wave inversion due to ischemia
Echocardiography
How to manage SVT?
- Circulatory and respiratory support
- Vagal stimulating manoeuvres
- IV adenosine - induces AV lock
- Electrical cardio version
What is rheumatic fever?
Inflammatory disease that develops 2-4 weeks post strep Group B infection.
Affects children 5-15 years
Long term damage can lead to mitral stenosis.
Signs and symptoms of mitral stenosis?
Polyarthritis (tender joints, swelling)
- Pericarditis (endocarditis, myocarditis, pericarditis)
- Erythema marginatum (map-like outlines)
- Sydenham’s chorea 2-6 months later – involuntary movements
How to manage Rheumatic Fever?
Immediate
- bed rest and anti-inflammatory agents
- high dose aspirin
- antibiotics
- corticosteroids
Prophylaxis - monthly injections of benzathine penicillin
Surgical treatment - valve replacement
What is Infective Endocarditis?
Infection of the inner surface of the heart - usually the valves.
What are some the signs and symptoms of Infective Endocarditis?
Fever, anaemia, pallor Clubbing, splinter haemorrhages
o Necrotic skin lesions (infected emboli) Changing cardiac signs
o Splenomegaly Neuro signs from cerebral infarct
o Retinal infarcts Arthritis or arthralgia
o Microscopic haematuria
How to diagnose Infective Endocarditis?
multiple blood cultures (before ABX) and echocardiography to identify vegetations
How to manage Infective Endocarditis?
Most commonly caused by streptococcus viridians
o High dose penicillin in combination with aminoglycoside (gentamicin or streptomycin) for 6w IV
§ Beta-lactam (i.e. amoxicillin) plus aminoglycoside (i.e. gentamycin)
§ Antibiotic prophylaxis is not used in the UK regularly
o Surgical removal of infected prosthetic material
What is cardiac failure?
is a set of manifestations caused by the failure of the heart’s function as a pump supporting the blood flow through the body;
What are some signs and symptoms of cardiac failure?
Shortness of Breath Poor feeding Recurrent chest infections Fatigue poor weight gain tachypnoea tachycardia hepatomegaly respiratory distress pallor
Causes of heart failure?
Neonate - hypoplastic LH, aortic stenosis
Infant - persistent VSA, ASD, PDA
Older Children - rheumatic HD, cardiomyopathy
Investigations for Heart failure?
Basic – O2 sats, BP, FBC, U&Es, Ca2+, BNP/ANP
o CXR
o ECG
o Echocardiography
