Heart murmurs and congenital heart disease Flashcards
Early soft systolic vibratory murmur heard over lower left sternal edge, louder when supine
Still’s murmur
Ejection systolic murmur, heard at the upper left sternal edge, does not radiate to back, no fixed splitting of S2
Pulmonary flow murmur
Low pitch continuous murmur heard below the right clavicle, louder when erect
Venous hum
Ejection systolic murmur, heard at the upper left sternal edge, radiates to back
Branch pulmonary stenosis
What are the 4 abnormalities that make up tetralogy of fallot?
- RV hypertrophy
- RV outflow obstruction
- VSD
- Overarching aorta
What are the Sx and signs of ToF?
Cyanosis (first day of life) Tet spells Failure to thrive Clubbing SOB Difficulty feeding Murmur
Pan systolic murmur heard at lower left sternal edge
VSD
Boot shaped heart on CXR
ToF
What is the management of a VSD?
Small VSDs will close spontaneously
Surgical correction of large VSDs should be performed by 12 months of age to prevent the development of pulmonary HTN
Soft ejection systolic murmur in the upper left sternal edge is heard, with fixed splitting of S2
ASD
What is the management of a ASD?
Often do not close spontaneously so requires Rx if symptomatic
If significant, correction is usually performed 3-5 years of age
What is a PDA?
Patent Ductus Arteriosus - a failure of the ductus arteriosus to close following birth
Bounding pulses
PDA
What is the management for a PDA?
Symptomatic premature infants -
NSAID (indomethacin) to close the PDA
Asymptomatic mature infants - embolisation coil or occlusion device
A child presents with weak femoral pulses, radio-femoral delay and relative HTN in upper limbs compared to lower limbs
Coarctation of aorta (a narrowing of the descending aorta)
What is the management for coarctation of aorta?
Balloon angioplasty or open surgical repair
What is transposition of great arteries?
When the aorta attaches to the right ventricle and the pulmonary artery connects to the left ventricle
What are the Sx and signs of TGA?
Presents neonatally (very soon after birth, when ductus arteriosus closes) with cyanosis and circulatory compromise
What is the management of TGA?
Prostaglandins to keep DA patent
Corrective surgery
