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Paeds AM > Congenital cardiac abnormalities > Flashcards

Congenital cardiac abnormalities Flashcards

1
Q

What are the main types of VSD?

A

Subaortic
Perimembranous
Muscular

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2
Q

What is VSD associated with?

A

Down’s

Turner’s

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3
Q

What is the presentation of VSD?

A

Pansystolic murmur- harsh, loudest at lower left sternal edge
Poor feeding
Dyspnoea, tachypnoea
Failure to thrive
LR shunt- right heart failure, pulmonary hypertension
Severe- heart failure

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4
Q

What is the management of VSD?

A

Closure- trans catheter or surgical

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5
Q

What is a complication of VSD?

A

Eisenmenger syndrome

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6
Q

What is Eisenmenger’s syndrome?

A

Pressure in R heart greater than L heart, so shunt reverses R to L –> cyanosis

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7
Q

What is the presentation of ASD?

A

Generally well in early childhood
Failure to thrive, poor feeding, dyspnoea
Wide fixed splitting of 2nd heart sound
Pulmonary flow murmur- cresendo decrescendo murmur
L–> R shunt- right heart failure, pulmonary hypertension

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8
Q

What is the management of ASD?

A

Good chance of spontaneous closure

Closure- trans catheter, surgical

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9
Q

What are the complications of ASD?

A

AF
Heart failure
Pulmonary hypertension
Eisenmenger’s syndrome

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10
Q

What is AVSD?

A

Single AV valve with ostrium primum ASD and high VSD

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11
Q

What is AVSD associated with?

A

Down’s

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12
Q

What is patent ductus arteriosus?

A

Connection between pulmonary trunk and descending aorta- usually closes with first few days due to prostaglandins

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13
Q

Who is PDA common in?

A

Pre term babies

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14
Q

What is the presentation of PDA?

A

Left subclavicular thrill
Continuous murmur
Large volume bounding collapsing pulse

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15
Q

What is the management of PDA?

A

Indomethacin- works in majority of cases

Closure with umbrella device

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16
Q

What is coarctation of the aorta?

A

Congenital narrowing of descending aorta

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17
Q

What is coarctation of the aorta associated with?

A

Turner’s

Males > females

18
Q

What is the presentation of coarctation of the aorta?

A 
Heart failure
Radio femoral delay
Weak femoral pulses
Hypertension in arms, hypotension in legs
Midsystolic murmur, maximal over back
19
Q

What is th management of coarctation of aorta?

A 
Mild= watch and wait
Severe= prostaglandin A to keep PDA open until surgery
20
Q

What are the pathologies in tetralogy of Fallot?

A

VSD
Overriding aorta
Pulmonary stenosis
RV hypertrophy

21
Q

What are the risk factors for Tetralogy of Fallot?

A

Maternal rubella

22
Q

What s the presentation of Tetralogy of FAllot?

A

Ejection systolic murmur
Heart failure before 1 yo
Cyanosis
Tet spells- R to L shunt becomes worse upon exertion

23
Q

What investigations are done for tetralogy of FAllot?

A

Echo and Doppler

CXR- boot shaped heart

24
Q

What is th management of tetralogy of FAllot?

A

Total surgical repair by open heart surgery

25
Q

What is transposition of the great arteries?

A

Aorta connected to RV and pulmonary trunk to LV

26
Q

What is essential for survival with TGA?

A

Shunt between circulations- ASD, VSD, PDA

27
Q

What is the presentation pf TGA?

A

Failure to thrive, cyanosis, tachycardia

28
Q

What is the diagnosis and management of TGA?

A

Often diagnosed during pregnancy

Immediate arterial switch procedure

29
Q

What is aortic stenosis associated with?

A

William’s

30
Q

What is the presentation of aortic stenosis?

A

Usually asymptomatic
Ejection systole murmur- upper R sternal border, radiation to carotids
Slow rising pulse, narrow pulse pressure

31
Q

What is the presentation of severe aortic atenosis?

A

Reduced exercise tolerance
Exertional chest pain
Syncope

32
Q

What investigations are done for aortic stenosis?

A

Echo
ECG
Exercise tolerance test

33
Q

What is the management of aortic stenosis?

A

Percutaneous balloon valvuloplasty
Surgical valvotomy
Valve replacement

34
Q

What is associated with pulmonary stenosis?

A

Noonan

Tetralogy of Fallot

35
Q

What is the presentation of pulmonary stenosis?

A

Mild= asymptomatic
Ejection systolic murmur- upper left sternal border. radiation to back
Severe- severe external dyspnoea, fatigue, raised JVP, RV heave and hypertrophy

36
Q

How is pulmonary stenosis investigated?

A

Echo

37
Q

What is the management of pulmonary stenosis?

A

Mild= watch and wait
Balloon valvuloplasty
Failure= open heart surgery

38
Q

What is Ebstein’s anomaly?

A

Low insertion of tricuspid valve resulting in large R atrium and small ventricle

39
Q

What is Ebstein’s anomaly associated with?

A

Lithium in utero

Wolff Parkinson White

40
Q

What is the management of Ebstein’s anomaly?

A

Surgery

Paeds AM (28 decks)

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