Heart Defects and Murmurs Flashcards
What heart defects are cyanotic?
Transposition of the great arteries
Tetralogy of Fallot
Triscuspid or pulmonary valve atresia
What is an innocent heart murmur?
Common benign murmurs during childhood
What are the causes of an innocent heart murmur?
Still’s murmur
Venous hum
Acute infective illness
What are the features of innocent murmurs?
6 Ss
- Soft
- Systolic
- Sensitive
- Short
- Single
- Small
What is the management of an innocent murmur?
Review in a few weeks
What is coarctation of the aorta?
Narrowing of the aorta (typically just before the ductus arteriosus
What is the presentation of coarctation of the aorta?
Varies on severity:
- Systolic murmur heard loudest between the scalpulae
- Radio-femoral delay
- Hypertension
- Heart failure
What genetic condition is coarctation of the aorta associated with?
Turner’s syndrome
What are the management options for mild coarctation?
Monitoring using echocardiogram
Antihypertensives
What are the management options for more severe coarctation?
Angioplasty - stent placement
Surgery
What type of murmur is heard with a patent ductus arteriosus?
Machine wirring murmur
- throughout the cardiac cycle
What is the medical treatment of a patent ductus arteriosus?
NSAIDs (indomethacin)- inhibit prostaglandin synthesis that promotes patency
What is Ebstein’s anomaly?
Caused by lithium use in pregnancy - the tricuspid valve doesn’t form properly, leading to a large right atrium and a small left ventricle
What is the most common congenital cardiac abnormality?
VSD
What murmur is associated with a VSD?
Pan-systolic murmur heard loudest at the left lower sternal edge
What is transposition of the great arteries?
Aorta comes out of the right ventricle
Pulmonary artery comes out of the left ventricle
What are the maternal risk factors for congenital heart disease?
Infectious diseases during pregnancy
Type 1 and 2 diabetes (pre-existing)
Teratogenic medicines
Substance abuse
What is Eisenmenger syndrome?
When a left-to-right shunt is reversed to a right-to-left shunt
How does eisenmenger syndrome occur?
Increased pulmonary vascular pressure as a cause of the left-to-right shunt causes pulmonary hypertension
Pulmonary hypertension results in the reversal of the shunt
What is the presentation of Eisenmenger’s syndrome?
Typically presents in late teens
Cyanosis
Right heart failure
What is the prognosis of Eisenmenger’s?
Irreversible
Often progresses to heart failure in 40s
What is the treatment of Eisenmenger’s?
Prevention
Heart-lung transplant
What medication can be used to keep the ductus arteriosus open?
Prostaglandin E
What is triscupsid atresia?
A condition where the triscuspid valve does not form
What is a venous hum?
A continuous blowing noise below the clavicles, due to the sound of venous return
What is Still’s murmur?
A low pitched sound heard at the lower left sternal edge created by blood flow through the heart
What sound is associated with an ASD?
Ejection systolic murmur heard loudest over the upper left sternal angle
What sound is heard in coarctation of the aorta?
Murmur heard on the back between the scapulae
What murmur is associated with tetralogy of fallot?
A harsh ejection systolic murmur heard loudest over the upper-left sternal angle
