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Y4R6 - Pediatrics II 👶 > L4: Acyanotic Heart Diseases - PDA & ASD > Flashcards

L4: Acyanotic Heart Diseases - PDA & ASD Flashcards

1
Q

Incidence of PDA

A
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2
Q

Anatomy of PDA

A
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3
Q

Pathophysiology of PDA

A
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4
Q

Pathophysiology of PDA

The extent of the shunt depends on:

A
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5
Q

There is a wide pulse pressure (due to runoff of blood into PA during diastole)

A

….

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6
Q

Why isolated large PDA is not a cause of heart failure in neonates?

A
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7
Q

Symptoms of Small PDA

A

Asymptomatic

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8
Q

Signs of Small PDA

A
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9
Q

Signs of Small PDA

  • Inspection & Palpation
A
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10
Q

Signs of Small PDA

  • Precordial Bulge
A

Normal

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11
Q

Signs of Small PDA

  • Precordial Activity
A

Normal

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12
Q

Signs of Small PDA

  • Apex
A
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13
Q

Signs of Small PDA

  • Pulsation
A
  • 2nd left space
  • Radiate to: 2nd left clavicle - left parasternal border - apex
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14
Q

Signs of Small PDA

  • Thrill
A

Continous

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15
Q

Signs of Small PDA

  • Auscultation
A
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16
Q

Signs of Small PDA

  • Heart Sounds
A

Normal

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17
Q

Signs of Small PDA

  • Murmur
A
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18
Q

Murmur in Small PDA

  • Site
A

2nd Left intercostal space “pulmonary area”

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19
Q

Murmur in Small PDA

  • Characters
A

Machinery or rolling thunder murmur (Gibson’s murmur)

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20
Q

Murmur in Small PDA

  • Radiation
A

Down the left sternal border or to the left clavicle

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21
Q

Murmur in Small PDA

  • Timing
A
  • Continuous
  • Reaches maximal intensity at end of systole & Wanes in late diastole
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22
Q

Murmur in Small PDA

  • If Increased PVR —> Decreased Diastolic component or may disappear
A

…

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23
Q

Murmur in Small PDA

  • Others
A
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24
Q

Complications of Small PDA

A
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25
Q

Investigations for Small PDA

A
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26
Q

Investigations for Small PDA

  • Chest X-Ray
A

Normal

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27
Q

Investigations for Small PDA

  • ECG
A

Normal

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28
Q

Investigations for Small PDA

  • ECHO
A

Normal

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29
Q

Investigations for Small PDA

  • Catheter
A
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30
Q

TTT of Small PDA

A
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31
Q

Prognosis of Small PDA

A

Mortality < 1%

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32
Q

Symptoms of Large PDA

A
  • Heart failure
  • FTT
  • Growth restriction
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33
Q

Signs of Large PDA

34
Q

Signs of Large PDA

  • General
A
  • Water hammer pulse = Bounding pulse = wide pulse pressure
35
Q

Signs of Large PDA

  • Inspection & Palpation
36
Q

Signs of Large PDA

  • Precordial Bulge
36
Q

Signs of Large PDA

  • Precordial Activity
36
Q

Signs of Large PDA

  • Apex
36
Q

Signs of Large PDA

  • Pulsation
A
  • 2nd left space
  • Radiate to: left clavicle - left parasternal border - apex
36
Q

Signs of Large PDA

  • Thrill
37
Q

Signs of Large PDA

  • Auscultation
38
Q

Signs of Large PDA

  • Heart Sounds
39
Q

Signs of Large PDA

  • Murmur
40
Q

Murmur in Large PDA

41
Q

Murmur in Large PDA

  • Site
A

2nd Left intercostal space “pulmonary area”

42
Q

Murmur in Large PDA

  • Characters
A

Machinery or rolling thunder murmur (Gibson’s murmur)

43
Q

Murmur in Large PDA

  • Radiation
A

Down the left sternal border or to the left clavicle

44
Q

Murmur in Large PDA

  • Timing
A
  • Continuous
  • Reaches maximal intensity at end of systole & Wanes in late diastole
45
Q

Murmur in Large PDA

  • If increased PVR —> Decreased Diastolic component or may disappear
46
Q

Murmur in Large PDA

  • Others
47
Q

Complications of Large PDA

48
Q

Investigations of Large PDA

49
Q

Investigations of Large PDA

  • Chest X-Ray
A
  • Prominent pulmonary artery
  • Increased PVM
  • LAE & LVE
  • Normal / Prominent aortic knob
50
Q

Investigations of Large PDA

  • ECG
A

LVE +- RVE

51
Q

Investigations of Large PDA

  • ECHO
A
  • LAE & LVE
  • Direct visualization of PDA
52
Q

Investigations of Large PDA

  • Catheter
53
Q

TTT of Large PDA

54
Q

Prognosis of Large PDA

A

Mortality < 1%

55
Q

Incidence of ASD

A

6 - 8% of congenital heart disease

56
Q

Types of ASD

57
Q

Types of ASD

  • Most Common
A

Secundum ASD

58
Q

Pathophysiology of ASD

A
  • Post-Natal Physiology
  • Adaptive Mechanisms
59
Q

Pathophysiology of ASD

  • Post-Natal Physiology
60
Q

Pathophysiology of ASD

  • Adaptive Mechanisms
61
Q

CP of ASD

A
  • Symptoms (Large)
  • Signs
62
Q

CP of ASD

  • Symptoms (Large)
63
Q

Signs of ASD

64
Q

Signs of ASD

  • Inspection & Palpation
65
Q

Signs of ASD

  • Auscultation
66
Q
  • Diastolic murmur of tricuspid stenosis is similar to that of mitral stenosis
  • Except that it’s heard best at the left lateral sternal border and may radiate to the apex or xiphoid.
67
Q

Small ASD is asymptomatic and there are no significant findings on auscultation.

68
Q

Investigations for ASD

69
Q

Investigations for ASD

  • Chest X-Ray
70
Q

Investigations for ASD

  • ECG
A
  • RT axis deviation
  • RAE & RVE
  • rsR’ Pattern on V1
71
Q

Investigations for ASD

  • ECHO
A

Same as VSD

72
Q

Investigations for ASD

  • Catheter
A

Indications:

  • Atypical finding
  • Trans-catheter closure (therapeutic)
73
Q

Complications of ASD

74
Q

Managmenet of ASD

75
Q

Management of ASD

  • Medical
76
Q

Management of ASD

  • Surgical
77
Q

Prognosis of ASD

A
  • Once pulmonary HTN occur, shunt reversal occurs (that is too late)
  • Mortality < 1%.
78
Q

Done

Y4R6 - Pediatrics II 👶 (10 decks)

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