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CMT-uno > Congenital heart > Flashcards

Congenital heart Flashcards

1
Q

Cyanotic diseases

A

Tetralogy of Fallot
Hypoplastic left heart syndrome
Transposition of Great Vessels
Pulmonary Atresia

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2
Q

Acyanotic

A

Acyanotic

Ventricular Septal Defect (VSD)
Patent Ductus Arteriosus (PDA)
Atrial Septal Defect
Coarctation of the Aorta

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3
Q
A
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4
Q
A
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5
Q

cyanotic

Transposition of the Great Vessels

A
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6
Q

Transposition of the Great Vessels

Presentation

cyanotic

A

Problems breathing/ cyanosis
Poor feeding

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7
Q

Transposition of the Great Vessels

PE and murmur

A

Physical exam:
Weak pulse
Ashen or bluish skin color

Murmur: systolic

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8
Q

Arterial Switch Operation

A
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9
Q

Hypoplastic Left heart Syndrome (HLHS)

general

A
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10
Q

HypoplasticLeft Heart Syndrome syndrome (HLHS)

presentation & murmur

A

Presentation:
Shock
Cyanosis
Murmur: variable ( depends assoc defects ((usu ASD))
More common in males
25% cardiac death before 7 days old

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11
Q

HypoplasticLeft Heart Syndrome (HLHS)

Tx

A
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12
Q

Pulmonary Atresia

general

A

Pulmonary valve did not form. No blood flow from R ventricle to the pulmonary artery
2 types:
With VSD or without
Can be detected on screening u/s in utero and then fetal ultrasound

*cyanotic
*Critical congenital disease

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13
Q

Pulmonary Atresia

presentation and Tx

A

Presentation:
Cyanosis, blue
Murmur: depends assoc VSD/MR/TR
Hyperdynamic apical impulse
Treatment:
Rx to keep the PDA open
Usually surgery- stent PV and patch VSD

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14
Q

tetralogy of Fallot

general

A

1)VSD
2)Pulmonary stenosis
3)RVH
4) Overriding aorta

*critical congenital disease
*cyanotic

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15
Q
A
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16
Q

Tetralogy of Fallot

preentation/murmur

A

Presentation:
Cyanosis
Polycythemia
Agitation
Murmur: crescendo-decrescendo holosystolic LSB radiate to back

17
Q

tet of fallot

PE

A

Clubbing
“tet spell”
Squatting
Boot shaped heart
Nail clubbing

18
Q

T of fallot

Dx and Tx

A

Diagnosis: echocardiogram
Treatment:
Surgery in first 4-12 months of life

19
Q

VSD (vent sept defect)

general

A

Communication between the ventricles
4 types:
1) Conoventricular Ventricular Septal Defect
2) Perimembranous Ventricular Septal Defect
3) Inlet Ventricular Septal Defect
4) Muscular Ventricular Septal Defect

Noncyanotic
*most common of all congenital heart defect

20
Q

VSD

presentation /murmur

A

Presentation
Weakness
Fatigue
Poor feeding
Doe
Failure to thrive ( poor weight gain)

Murmur: loud high pitched harsh holo-systolic M LLSB; does not change with position

21
Q

VSD

Dx and Tx

A

Diagnosis: Echocardiogram
Treatment:
Closure depending on size and symptoms
Ideally wait until > 35 lbs

22
Q

PDA Patent ductus arteriosus

general

A

ductus arteriosus fails to close after birth; oxygenated blood from the L heart can flow back to the lungs via the aorta- can lead to pulmonary HTN

See in premies
Treatment with prostaglandin synthesis inhibitors ( indomethacin)
Treatment depends on size- closure device vs ligation

Creates a L to R shunt (Eisenmenger’s syndrome)

23
Q

PDA

A
24
Q

PDA

presentation and murmur

A

Presentation
Weight loss with poor feeding
Pulmonary congestion
Frequent pulmonary infections

Murmur: continuous machinery murmur

Wide pulse pressure, bounding pulses
Hyperdynamic apical pulse
More likely in premies

25
Q

ASD

A

25% of live births
Communication between the R and L atria
If R to L shunting, allows deoxygenated blood to dilute oxygenated blood in the Left atrium

3 types:
Ostium secundum ( most common/ 80%)
Ostium primum
Sinus venosus

Closure indicated depending on the size/shunt
Closure indicated if develop right to left shunt
*suspect if cryptogenic stroke!!!

26
Q

Atrial Septal Defect (ASD)

presentation and murmur

A

Presentation:
Frequent respiratory or lung infections
Difficulty breathing
Tiring when feeding (infants)
Shortness of breath when being active or exercising
Skipped heartbeats or a sense of feeling the heartbeat
Swelling of legs, feet, or stomach area
Stroke

Murmur: systolic 2 LICS “ rumble”, RV heave
Work up: “bubble study” on echocardiogram

27
Q

Coarctation of Aorta

A

Emergency*
The descending proximal thoracic aorta is narrowed

28
Q

Coarctation of Aorta

presentation and murmur

A

Presentation:
pale skin
irritability
heavy sweating
difficulty breathing
hypertension
Murmur: LUSB continuous, radiates to the back
Decreased pulses to lower extremities/groin
Difference b/t upper and lower pulses/bp is pathognomonic**

29
Q

Coarctation of Aorta

Dx and Tx

A

Diagnosis:
Cxray: rib notching and “3”sign
angiogram (gold standard)
Treatment:
Balloon angioplasty +/- stent vs surgical repair

Will almost always have a bicuspid aortic valve
*increased instance intracranial aneurysm

30
Q

Side step: cryptogenic stroke

A

Cannot find a cause of emboli ( no clot, afib, emboli, endocarditis, cad, hypercoagulable syn )
Consider 30 day event monitor to rule out undiagnosed afib
Echo/tee with bubble study to look for shunt!!!

31
Q

Infant born at 32 weeks has loud continuous machinery like murmur; what is best test?
what is best test?
Cxray
Heart cath
Mri heart
Echocardiogram

What medication may be given?
indomethacin
clopidogrel
Antibiotics
diuretics

A

Echocardiogram

indomethacin

(Continuous machinery like murmur think PDA)

32
Q

4 yo presents pediatric clinic. Mother reports he gets winded easily. PE: lower extremities skinny, continuous systolic murmur LUSB. BP and pulses in BUE is > BLE

ASD
VSD
PDA
Coarctation of the aorta

A

Coarctation of the aorta

33
Q

Which of the following is NOT a component of Tetralogy of Fallot?
overriding aorta
RVH
ASD
VSD

A

ASD

34
Q

Murmur that increases with Valsalva?
HOCM
AS
MVP
AR

A

HCOM

35
Q
A
36
Q
A
37
Q

POTS

Tx

A

Treatment:
Liberalize salt, caution w position changes, compression hose, exercise
Rx: metoprolol, fludrocortisone, midodrine

38
Q
A
39
Q
A

CMT-uno (54 decks)

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