CV Flashcards
What is preload?
The volume of blood in the ventricles at the end of diastole.
What is afterload?
The resistance the heart must pump against to eject blood.
What is contractility?
The strength of the heart’s contraction, independent of preload and afterload.
How do preload, afterload, and contractility affect stroke volume?
↑ Preload = ↑ Stroke Volume
↑ Afterload = ↓ Stroke Volume
↑ Contractility = ↑ Stroke Volume
What should you inspect during a pediatric cardiac assessment?
Skin color, temperature, cyanosis (central vs peripheral), breathing effort, feeding issues, and JVD.
What should you palpate during a cardiac assessment?
Apical impulse (PMI), liver (hepatomegaly), peripheral pulses, and any thrills.
What should you auscultate for during a pediatric cardiac assessment?
Heart rate & rhythm
S1/S2 sounds
S3 (normal in kids)
S4 (abnormal)
Murmurs (location, quality)
What indicates ‘not normal’ in a pediatric cardiac exam?
S4 sound, thrills, weak pulses, hepatomegaly, poor feeding, cyanosis, or abnormal murmurs.
What are signs of cardiac failure in infants?
Poor feeding, sweating with feeds, tachypnea, hepatomegaly, cyanosis, poor growth.
What are signs of cardiac failure in older children?
Exercise intolerance, fatigue, edema, shortness of breath, poor school performance.
What causes congenital heart defects (CHD)?
Genetic: Trisomy 13/18/21, Turner, DiGeorge
Environmental: Rubella, coxsackievirus
Maternal: Diabetes, PKU, advanced age
What is an Atrial Septal Defect (ASD)?
A hole in the atrial septum that causes a left-to-right shunt and increased pulmonary blood flow.
What are signs of ASD?
-Often asymptomatic
-Large ASD can cause CHF, fatigue, poor growth, and a soft systolic murmur with fixed split S2.
What is a Ventricular Septal Defect (VSD)?
A hole in the ventricular septum causing a left-to-right shunt and increased pulmonary blood flow.
What are signs of VSD?
CHF, frequent respiratory infections, failure to thrive, harsh systolic murmur with a thrill at LLSB.
What is Patent Ductus Arteriosus (PDA)?
Failure of the ductus arteriosus to close, causing a left-to-right shunt between the aorta and pulmonary artery.
What are signs of PDA?
Bounding pulses, widened pulse pressure, tachypnea, “machinery” murmur, hepatomegaly if large.
What are the four defects of Tetralogy of Fallot (TOF)?
Pulmonary stenosis
Right ventricular hypertrophy
Overriding aorta
Ventricular septal defect
What is a ‘Tet Spell’ and how do you treat it?
Cyanotic/hypoxic episode.
Tx: Knee-chest position, oxygen, morphine, IV fluids, keep calm.
What is Coarctation of the Aorta (CoA)?
Narrowing of the aorta, usually near the ductus arteriosus, causing upper body HTN and lower body hypoperfusion.
What are signs of CoA?
Bounding upper pulses, weak femoral pulses, BP higher in arms than legs, possible lower extremity cyanosis.
What is Hypoplastic Left Heart Syndrome (HLHS)?
Underdeveloped LV with stenosed/absent aortic and mitral valves; fatal without PDA.
What are signs of HLHS?
Cyanosis, poor perfusion, weak pulses, CHF; symptoms worsen as PDA closes.
What is Transposition of the Great Arteries (TGA)?
Aorta arises from RV and PA from LV = two separate circuits. Fatal without PDA or other shunt.
