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COMAT - Peds > Congenital Heart Conditions > Flashcards

Congenital Heart Conditions Flashcards

1
Q

What type of shunt results in absent cyanosis?

A

Left to Right

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2
Q

What are 3 Left to Right Shunts?

A

3D’s
- ASD
- VSD
- PDA

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3
Q

Do Left to Right shunts typically present at birth?

A

NO – not causing cyanosis

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4
Q

What is a potential late complication of Left to Right shunts?

A

Eisenmenger Syndrome
= Increased blood flow to the lungs results in pulmonary HTN and eventually causes reversal of the shunt to Right to Left shunt

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5
Q

What is often heard with an ASD?

A

Wide and Fixed split S2

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6
Q

With both ASD’s and VSD’s what type of diastolic sound can be heard?

A

Mid-diastolic rumbles

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7
Q

What part of the heart may be enlarged with ASD’s?

A

Right atrial enlargement
Right ventricular hypertrophy

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8
Q

What is the treatment for most ASD’s and VSD’s?

A

NOTHING
– often close spontaneously
– surgery if severe symptoms are occurring

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9
Q

What is the most common type of congenital heart condition?

A

VSD

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10
Q

What is unique about the sound of the VSD?

A

The size of the VSD is inversely proportional to the intensity of the murmur
– Smaller VSDs = LOUDER murmurs

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11
Q

What is often heard with a VSD?

A

Harsh HOLOsystolic murmur at the lower left sternal border

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12
Q

What part of the heart is often enlarged with VSD’s?

A

Left ventricular hypertrophy
+/- Right ventricular hypertrophy

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13
Q

What does the PDA (patent ductus arteriosus) connect?

A

Aorta sends blood to Pulmonary A.

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14
Q

When should the PDA close?

A

First few days of life

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15
Q

If the PDA does not close, what type of murmur is often heard?

A

Continuous machinery like murmur at left 2nd ICS

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16
Q

If the PDA does not close, what type of murmur is often heard?

A

Continuous machinery like murmur at the left 2nd ICS

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17
Q

What are 2 other features that can be seen with PDA?

A

Wide pulse pressure
Bounding peripheral pulses

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18
Q

What is the pneumonic to remember what the treatment is for a PDA?

A

Come IN and CLOSE the door

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19
Q

What is the treatment in order to close the PDA?

A

Indomethacin (NSAID)

20
Q

If you want to keep the PDA open what should be given?

A

Prostaglandin E1

21
Q

Where is the aorta most often constricted with coarctation of the aorta?

A

Distal to the left subclavian artery

22
Q

What 2 things are often present with coarctation of the aorta?

A

Bicuspid aortic valve
Turner Syndrome

23
Q

With coarctation of the aorta and many other right to left shunt heart conditions, what is essential to survival?

A

PDA or a septal defect

24
Q

What is the main sign of Coarctation of the aorta?

A

UE HTN or uneven blood pressures between arms

25
Q

Besides UE HTN, what are 3 other signs of Coarctation of the aorta?

A
  • Weak femoral pulses
  • LE claudication
  • Radiofemoral delay
26
Q

What are 2 items that can be seen on CXR with coarctation of the aorta? Why?

A
  • Rib notching
  • 3 sign
    => Formation of collateral circulation
27
Q

If a patient is cyanotic with a heart condition, what type of shunt is present?

A

Right to Left

28
Q

How can you tell if a baby is cyanotic due to a heart condition or lung condition with supplemental oxygen?

A

Heart conditions hypoxemia will NOT correct with supplemental oxygen whereas lung conditions will

29
Q

What is a Breath Holding Spell?

A

Emotional trigger for a child causes loss of consciousness or cyanosis
- Will resolve with time; benign condition

30
Q

List 5 Right to Left shunts

A
  • Truncus Arteriosus
  • Transposition of great vessels
  • Tricuspid Atresia
  • Tetralogy of Fallot
  • Total anomalous pulmonary venous return
31
Q

What is the setup with Transposition of the great vessels?

A

Aorta connects to the RV and the Pulmonary A. connects to the LV
– BLOOD NEVER MIXES

32
Q

Transposition of the Great Vessels is not compatible with life unless?

A

A septal defect is present

33
Q

Will there be a murmur with Transposition of the Great Vessels?

A

Not unless there is a septal defect present

34
Q

What will the heart look like on CXR with Transposition of Great vessels?

A

Egg shaped heart with a narrow base

35
Q

What are 2 risk factors for development of Tetralogy of Fallot?

A

Maternal PKU
DiGeorge Syndrome

36
Q

What are the 4 things present with Tetralogy of Fallot?

A
  • Pulmonary stenosis
  • RV hypertrophy
  • Overriding aorta
  • VSD
37
Q

What are the 4 things present with Tetralogy of Fallot?

A
  • Pulmonary stenosis
  • RV hypertrophy
  • Overriding aorta
  • VSD
38
Q

What defect with Tetralogy of Fallot is the Right to Left shunt

A

VSD

39
Q

The cyanosis will develop over the first 2 years of life with Tetralogy of Fallot along with?

A

Dyspnea and fatiguability

40
Q

Why may a child squat with Tet spells?

A

Squatting relieves the hypoxemia by increasing systemic vasculature pressure and forces blood into the lungs

41
Q

What will the heart look like on CXR with Tetralogy of Fallot?

A

Boot shaped heart

42
Q

What is Total Anomalous Pulmonary Return?

A

Right heart –> Lungs –> Right heart

43
Q

With a majority of the Right to Left shunt heart conditions what should be given before surgery can be done?

A

PGE1 to keep the PDA open

44
Q

What does uncontrolled maternal diabetes cause to the heart?

A

Transient Hypertrophic Cardiomyopathy

45
Q

If a child has a thickened interventricular septum due to maternal diabetes, what is the treatment?

A

Nothing – will regress

COMAT - Peds (12 decks)

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