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Pediatrics > Congenital Heart Dz > Flashcards

Congenital Heart Dz Flashcards

1
Q

VSD

A

Most common cause of congenital heart dz.

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2
Q

Apert’s Syndrome

A

VSD. Cranial deformities. Fusion of fingers and toes

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3
Q

Down’s Syndrom

A

VSD, ASD

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4
Q

Fetal Alcohol Syndrome

A

VSD, ASD

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5
Q

TORCH

A

Toxo. Other (syphillis), Rubella, CMV, HSV.

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6
Q

Cri du chat

A

VSD. 5p deletion

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7
Q

Trisomies 13 and 18

A

13 - Patau
18 - Edwards
VSD

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8
Q

Harsh, holosystolic murmur. Heard best at lower, left sternal border

A

VSD

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9
Q

Frequent resp infections, dyspnea, FTT, CHF. Softer, more blowing murmur. systolic thrill, crackles, hepatomegaly, narrow S2, inc P2. Mid-diastolic apical rumble (inc flow across mitral valve).

A

Large VSD

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10
Q

VSD diagnosis

A
  • ECHO
  • EKG = LVH (maybe LVH and RVH)
  • CXR = cardiomegaly, Inc pulm vasc markings
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11
Q

VSD tx

A

Small - most close spon (monitor with ECHO), abx only if previous closure with prosthetic material.
Surgery - if fail medical management, children <1 with PHTN, older children with persistent, large VSD
Med Management - CHF w/ diuretics, inotropes, ACEIs

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12
Q

ASD, absent radii, first degree heart block

A

Holt-Oram Syndrome

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13
Q

Fixed, widely-split S2. right ventricle heave

A

ASD

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14
Q

Eisenmenger’s Syndrome

A

Right-to-Left shunting, cyanosis.

Leads to PHTN and shunt reversal.

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15
Q

ASD EKG

A

RVH. R atrial enlargement. PR prolongation.

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16
Q

ASD CXR

A

cardiomegaly. Inc pulm vasc markings

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17
Q

ASD tx

A

90% close spon

18
Q

ASD surgical repair

A

infants with CHF. Pt with more than 2:1 pulm to systemic blood flow

19
Q

Cont “machinery murmur” @ 2 LICS. Loud S2. Wide pulse pressure. Bounding peripheral pulses.

A

PDA

20
Q

PDA dx

A

color flow Doppler, showing flow from aorta to pulm artery

21
Q

PDA tx

A

indomethacin (unless PDA is needed for survival or indomethacin is contraindicated, IV hemorrhage)
-If indomethacin fails or child is >6-8mo, surgical closure is required.

22
Q

Coarc - most common site

A

just below the subclavian (98%)

23
Q

Coarc pts with bicuspid aortic valve

A

2/3

24
Q

Murmur over the back, between the scapulae

A

Coarc

25
Q

CXR - “3” sign and rib notching

A

Coarc

26
Q

Coarc tx

A

PGE1 - keeps ductus open

Monitor for restenosis, aneurysm, and dissection

27
Q

Most common cyanotic congenital heart lesion in a newborn

A

Transposition of the great vessels

28
Q

CATCH 22

A

DiGeorge Syndrome

Cardiac abnormalities (transposition)
Abnormal facies
Thymic aplasia
Cleft palate
Hypocalcemia

22q11 deletion

29
Q

Transposition s/s

A

Cyanosis within first few hours

tachypnea, progressive hypoxemia, extreme cyanosis

30
Q

Transposition dx

A

ECHO

CXR - narrow heart base, “egg-shaped silhouette” and Inc pulm vasc markings

31
Q

Transposition tx

A

PGE1 - maintain PDA
Balloon septostomy
Surgical correction is definitive

32
Q

Tetralogy of Fallot - components

A

Pulm stenosis, overriding aorta, RVH, and VSD

33
Q

Most common cyanotic congenital heart disease in children

A

Tetralogy of Fallot

34
Q

Tetralogy - risk factors

A

maternal PKU, DiGeorge Syndrome

35
Q

Tetralogy - H/PE

A

Freq absent at birth - dev over first 2yrs of life

4-6 mo: CHF, manifests as diaphoresis with feeding or tachypnea

36
Q

Child squats for relief during hypoxemic episodes

A

Tet spells

squatting INC systemic vascular resistance

37
Q

Tetralogy dx

A

ECHO and catheterization
CXR - boot-shaped heart, dec vasc markings
ECG - RVH and r-axis deviation

38
Q

“Boot-shaped” heart with DEC pulm vasc markings

A

Tetralogy

39
Q

Tet spell tx

A

O2, propranolol, phenylephrine, knee-chest position, fluids, morphine

40
Q

Tetralogy tx

A

PGE1, surgery

Pediatrics (7 decks)

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