[MS] Cardiology Flashcards
What pathology is indicated with a persistent, widely split S2 heart sound?
ASD, RBBB, or pulmonic stenosis
What pathology is indicated with a paradoxically split S2 heart sound?
Severe aortic stenosis or LBBB
What heart sound is almost always abnormal?
S4
What kinds of heart murmurs increase with the Valsalva maneuver?
Hypertrophic cardiomyopathy or obstructive left-sided heart lesions
What is the calculation for heart rate from the ECG?
1500 / RR interval
What syndrome is associated with a prolonged QT interval, syncope, and hearing loss?
Jervell and Lange-Nielsen syndrome
What electrolyte abnormalities cause a prolonged QT interval?
Hypocalcemia
Hypomagnesemia
Hypokalemia
What are the electrocardiographic findings associated with Brugada syndrome?
RV conduction delay
ST elevation in leads V1 to V3
What electrolyte abnormality can cause a shortened QT interval?
Hypercalcemia
What is the most common cause of pediatric cardiac chest pain?
Pericarditis
What disease causes elevated ST segments in all ECG leads?
Pericarditis
What is the normal duration of the QRS interval?
Less than 120ms
What are the electrocardiographic findings associated with Mobitz I (Wenckebach phenomenon)?
Progressive prolonging of the PR interval until there is a drop in the QRS
What is the classic ECG finding associated with a right bundle branch block?
“Rabbit ears” of lead V1
What types of children typically develop sick sinus syndrome?
Those that underwent atrial surgery such as ASD closure or Fontan procedure
What drug can precipitate heart failure in patients with atrial flutter?
Verapamil
What is the treatment for patients with unstable supraventricular tachycardia?
DC Cardioversion
What is the treatment for patients in atrial flutter/fibrillation who have known Wolff-Parkinson-White syndrome?
IV Procainamide
What is the preferred treatment for stable patients with ventricular tachycardia?
Amiodarone
What is a known side effect of Procainamide?
Drug-induced Lupus
What electrolyte disturbances typically exacerbate Digoxin toxicities?
Low potassium
High calcium
What is the most common congenital heart lesion?
VSD`
What congenital heart lesion is associated with Lithium?
Ebstein’s anomaly
What genetic diseases are classically associated with pulmonic stenosis?
Noonan syndrome, Alagille syndrome
What genetic diseases are classically associated with a VSD?
Apert syndrome, Cri-du-chat syndrome, Trisomy 18, Trisomy 13
What is a primary indication for closure of a VSD?
If shunts result in twice the normal amount of pulmonary blood flow
What is an important sequelae of long-term, unrepaired atrial septal defects?
Eisenmenger syndrome
What is the most common congenital heart lesion of Trisomy 21?
Endocardial cushion defect
What is the most common cause of mitral regurgitation, both worldwide and in the US?
Worldwide - Rheumatic Fever
US - Mitral Valve Prolapse
What medications act as cardiac afterload reducers?
ACE Inhibitors
Hydralazine
What positions can increase the murmur heard with mitral valve prolapse?
Sitting or Standing
What is the second most common of the congenital cardiac defects?
Pulmonic stenosis
What is a critical indication to start PGE1 therapy in neonates?
Critical pulmonary stenosis
What is the cause of the majority of cases of congenital aortic stenosis?
Bicuspid aortic valve
What is the next step to perform if a child with known aortic stenosis presents with syncope?
Cardiac catheterization, balloon angioplasty, or surgery
What happens to the murmur of aortic stenosis when children squat?
The sound with increase, which is opposite of what happens with hypertrophic cardiomyopathy
What syndrome is associated with isolated supravalvular aortic stenosis?
Williams syndrome
What syndrome is associated with true interruption of the aortic arch?
DiGeorge syndrome – use FISH analysis to look for 22q11 mutation
What are major complications that children with unrepaired Tetralogy of Fallot experience?
Brain abscesses
Cerebral Thrombosis
Infective Endocarditis
What antenatal medication is typically used in infants with Tetralogy of Fallot?
Prostaglandin E1
By what age should patient’s with Tetralogy of Fallot receive correction?
6 to 12 months, if not earlier
What congenital heart defects present with a left axis deviation?
Ostium Primum ASD
Complete AV Canal
Tricuspid Atresia
What form of TAPVR is associated with more severe pulmonary edema and cyanosis?
Subdiaphragmatic form
What congenital heart lesion is associated with a “figure 8” or a “snowman” on chest x-ray?
TAPVR
What is Beck’s triad and what is it associated with?
Increased jugular venous pressure with inspiration, dropping systolic blood pressures, and muffled heart sounds, all associated with Cardiac Tamponade
What medications are inotropic agents?
Dopamine, Dobutamine, Epinephrine, Milrinone, and Digoxin
What are the symptoms of acute digoxin toxicity?
Nausea, vomiting, diarrhea, color-vision change, confusion, vertigo, and arrhythmias
What complication is associated with loop diuretic use in premature infants?
Nephrocalcinosis
What is a rare side effect of Spironolactone use?
Gynecomastia
What concerning diagnosis is associated with a sharp, “tearing” chest pain in patients with Marfan’s or Ehlers-Danlos syndromes?
Aortic Dissection
