Jeopardy 2- Cardio GI Flashcards
CHF drugs that increase the efficiency of contractions and can relieve tachycardia
Digoxin (Cardiac Glycosides)
% of children who at one point have an Innocent Heart Murmur
50%
Vibratory, twangy or buzzing systolic murmur heard at the mid LSB
Stills Murmur
Age group that have Stills Murmur
2-7
Continuous murmur heard at the neck and clavicles that disappears if supine
Venous Hum
Type of ASD seen in Down Syndrome
Ostium Primum
MOST COMMON type of ASD
Ostium Secundum
ASD that occurs in the middle of the septum
Ostium Secundum
ASD that occurs high in the septum and may –> anomalous return of the R. Pulm Veins into the R. Atrium
Sinus Venosus
Affect of ASD on pulm blood flow
Increases pulm blood flow
Ostium Primum ASD may result in ___ that causes CHF
Mitral Regurgitation
Murmur heard w/ ASDs
Fixed splitting of the second heart sound
Why is there splitting of the second heart sound w/ ASDs?
ASD –> increased pulm blood flow –> no more variation in timing of the aortic and pulmonic valve closure w/ respiration
Treatment of ASD
Surgical closure
High pitched holosystolic murmur at LLSB
VSD
Continuous machine-like murmur at ULSB
Patent Ductus Arteriosus
Systolic ejection murmur w/ radiation to carotids
Aortic Stenosis
Systolic ejection murmur at ULSB w/ a click
Pulmonic Stenosis
Direction of the shunt in VSD is determined by
Size of the VSD and Pulmonary Vascular Resistance
As a VSD becomes SMALLER the murmur…
INCREASES
VSDs large enough to cause >2:1 ratio of blood going to the lungs vs going to the systemic circulation may have what murmur and why?
Murmur of Mitral Turbulence (excess blood from the lungs is now passing through the mitral valve)
Reversal of L–>R shunt to R–>L shunt that occurs because PVR»_space; SVR
Eisenmenger Syndrome
Large shunts are associated w/
Increased risk of pulm infections
Ductus Arteriosus connects
Pulmonary Artery to the Aorta
Drug used to close a PDA
Indomethacin
The ACYANOTIC heart defects
1) ASD
2) VSD
3) PDA
4) Coarctation
5) Aortic Stenosis
6) Pulmonic Stenosis
50% of patients w/ coarctations may also have
Bicuspid Aortic Valves or Aortic Stenosis
To preserve circulation to lower body, the Ductus Arteriosus must be kept open in a coarctation patient via
PGE2
How is renal blood flow maximized in coarctation patients
Dopamine
Severe aortic stenosis may be associated w/
Hypoplasia of the Left Ventricle
Treatment for pulmonic stenosis
Balloon Valvuloplasty
The 5 CYANOTIC Heart defects
1) Truncus Arteriosus
2) Transposition of the Great Arteries
3) Tricuspid Atresia
4) Tetralogy of Fallot
5) Total Anomalous Pulmonary Venous Connection
MOST COMMON cause of central cyanosis after newborn period
Tetralogy of Fallot
4 Components of Tetralogy of Fallot
VSD, Pulmonic Stenosis, Over-riding Aorta and RV Hypertrophy
CXR showing upturned cardiac apex (boot shape)
Tetralogy of Fallot
CXR showing small heart w/ narrow mediastinum (egg on a string)
Transposition of the Great Arteries
CYANOTIC heart defects which are associated w/ Right Aortic Arch
Tetralogy of Fallot and Truncus Arteriosus
Things that worsen the R–>L shunting in Tetralogy of Fallot
1) Decreasing SVR (exercise, vasodilation, volume depletion)
2) Increase RVOT resistance (crying, tachycardia)
Things that would improve the R–>L shunting in Tetralogy of Fallot
Increase SVR and decrease RVOT resistance (volume infusion, HTN, Valsalva, brady)
How does squatting help in a Tet spell?
1) Increases SVR
2) Increased venous return
Treatment of Transposition of the Great Vessels
Arterial Switch Operation
Only cause of cyanosis in the newborn w/ LEFT AXIS DEVIATION and LEFT VENTRICULAR HYPERTROPHY
Tricuspid Atresia
MOST COMMON cause of acquired heart disease worldwide
Rheumatic Fever
MOST COMMON cause of acquired heart disease in the US
Kawasaki Disease
MOST COMMON causes of bacterial endocarditis
Gram + Cocci (Strep Viridans and Staph)
MOST IMPORTANT lab test in bacterial endocarditis
Blood Cultures
Tender swollen lesions on the palms, soles or toes/fingers in endocarditis
Osler’s Nodes
Erythematous hemorrhagic lesions on the palms or soles
Janeway lesions
Round or oval white spots in the retina w/ endocarditis
Roth’s Spots