CV Flashcards
DDX systolic ejection murmur at LUSB
ASD (dif bc mid diastolic rumble)
Tetralogy
Syndromes a/w VSD
FAT DCT
Fetal alcohol syndrome
Alpert syndrome
Trisomy 13,18
Downs
Cri du chat
TORCH
Syndromes a/w ASD
Holt Oram syndrome
Downs
Fetal alcohol
Syndromes a/w PDA
Rubella
Preme
Syndromes aw Transposition of the Great Vessels
DiGeorge
Maternal diabetes
Syndromes aw tetralogy
Maternal PKU
DiGeorge
Syndrome aw coarctation
Turners
Aperts syndrome
Cranial
Fusion of fingers and toes
IEM associated with heart problems
Maternal PKU
Homocystinuria
Drugs aw CHD
LAPTA
Lithium Amphetamines Phenytoin Thalidomide Alcohol
Two CHD’s on LLSB
VSD
Truncus arteriosus
Dx VSD
ECHO- LVH
CXR- CM, increase pulmonary vascular markings
Hyperoxia test
Tx VSD
Small= SPONT
- monitor
- antibiotic prophylaxis
Sx
- symptomatic and failed med tx
-
Holt Oram syndrome
Absent radius
Heart block - 1st degree
ASD
PC ASD early childhood
OSTIUM PRIMUM
- murmur
- exertional fatigue
PC ASD late childhood/ early adulthood
OSTIUM secundum
Dx ASD
ECHO- colour flow Doppler- bw atria
ECG- RV dilation, RA, PR elongation
CXR- CM, increase pulmonary vascular markings
Tx ASD
90% = SPONTANEOUS
10% sx
Surgical tx ASD
CHF
2:1 pulmonary: systemic
Surgical tx VSD
- symptomatic and failed medical tx
-
PC PDA
A symptomatic
LARGE:
- CHF
- SOB
- FTT
- recurrent LRTI
LL clubbing
Murmur VSD
Harsh holosysyolic LLSB
Murmur ASD
Systolic ejection LUSB and mid diastolic rumble
Murmur PDA
Continuous machine like murmur= infraclavicular
HY PDA
Murmur machine
Wide pulse pressure
Bounding peripheral pulses
Dx PDA
Colour flow
EVHO
ECG
CXR
( self explanatory)
Tx PDA
Indomethacin
Surgery
Surgery PDA
- failed indo tx
- child > 6-8 months
PDA for survival
- tetra
- hypo L heart
- transposition.
MCC cyanosis newborn
Transposition
MCC cyanosis child
Tetralogy
PC TRANSPOSITION.
SINGLE LOUD S2
CHF
Tachypnea/ hypox/ cyanosis
Dx transposition
ECHO
CXR
CXR transposition
Narrow heart base
Absence main pulmonary artery
Increase pul vasc marking
EGG ON A STRING HEART
Tx transposition
Indomethacin
Balloon atrial septostomy
Sx- arterial or atrial switch
PC tetralogy
Tet spells
CHF
FTT
mental status
Murmur in transposition
VSD
Murmur in tetralogy
SEM LUSB
Dx tetra
ECHO
CXR
ECG- RVH, R axis deviation
CXR TETRA
Boot shaped heart
DECREASE pul vasc markings
Tx TETRA
PGE1
Tet spells: oxygen/ propanolol/ morphine/ knees - chest
Balloon atrial septostomy
Sx: blalock Tussig shunt
Blalock Tussig Shunt
Sx tetra
Connect pulmonary artery to subclavian or carotid
— increasing blood to lungs
PC coarct
ASYMPTO
HTN UL
- epistaxis
- headache
- syncope
LL claudication
Weak femoral pulses
Radio femoral delay
Murmur COarct
Intra scapular
Short systolic L axilla
Dx coarct
ECHO colour flow
ECG
CXR
CXR coarct
3 sign
Rib notching
Tx coarct
PGE1
Sx or balloon ?
Monitor
- re stenosis
- aneurysm
- dissection
Truncus arteriosus
LARGE aw VSD
TAPVR
Aw ASD
CXR TAPVR
Snowman sign
Dx TAPVR
Wet lung fields
Polycythemia
Hypo L heart syndrome 4 things
Narrow or absent:
- mitral valve
- aortic valve
- —> hypoplastic LV
- ———–> AORTA:
- coarct
- small ascending
4 CHD more common in boys
- transposition
- coarct
- TAPVR
- hypoplastic L heart
Ebsteins anomaly
Malformed tricuspid valve
—> bulges into RV
(Atrialized RV)
Complications
- tricuspid stenosis
- tricuspid regurg
- RV dysfunction
- pulmonary stenosis
HOCM a/w
friederichs ataxia
noonan syndrome
pompe disease
hurlers
Vascular phenomena in IE Dukes Criteria
- septic pulmonary infarcts
- intracranial haemorrhage
- janeway lesions
- conjunctival injection
- mycotic aneurysm
- major artery emboli
immunologic phenomena in IE Dukes criteria
- roth spots
- osler nodes
- glomerulonephritis
- Rheumatoid factor
Dx SVT
- narrow QRS, 250-300bpm
- P wave after QRS
- severe heart failure= myocardial ischaemia, T wave inversion
- WPW
Tx SVT
- caridopulmonary support
- vagal activation– COLD ICE PACK, carotid sinus massage
- IV adneosine
- direct cardioversion
- maintenance:
- flecainide or sotalol
- digoxin
- propanolol
Tx WPW
- percutaneous radio”f” ablation
- cryoablation of accessory pathway
most common childhood arrhythmia
SVT
PC congenital heart block
MOST= ASYMPTOMATIC
hydrops
death in utero
heart failure
Long QT PC
late adulthood,
LOC
inheritance of long QT
AD
LONG QT a/w
- erythromycin
- hypoK/Mg
- head injury
features of an innocent murmur
soft systolic L sternal edge asymptomatic \+ postural and respiration \+ localized
types of innocent murmurs
- increase pulmonary artery flow murmur
- stills murmur
- venous hum
increase pulmonary artery flow murmur
preme’s
resolves in 1 week
stills murmur
mid LSB
turbulence across myocardial band of the LV
venous hum
ULSB
NOT there when flat
neonate causes of heart failure
CISH critical aortic stenosis interruption of arch of aorta severe AS hypoplastic L heart
infant causes of heart failure
3D’s
PDA
VSD
ASD
childhood causes of heart failure/ adolescent
eisenmenger syndrome
rheumatic heart disease
cardiomyopathy
side effects of prostaglandin
flushing vasodilation hypotension apnea jitteriness seizures