paed cardiology Flashcards
what are the 8 commonest lesions in paed cardiology ?
VSD PDA ASD pulmonary stenosis aortic stenosis coarctation of aorta transposition of great arteries tetralogy of Fallot
what environmental factors can cause cardiac defects ?
drugs - alcohol, amph, coke, MDMA, phenytoin, lithium
infection TORCH - toxoplas, rubella, CMV, HSV
maternal - DM, SLE
what defects are trisomies associated with ?
trisomy 13 - VSD, ASD
trisomy 18 - VSD, PDA
trisomy 21 - AVSD
what are other syndromes associated with ?
turner - co-arctation
noonan - pulmonary stenosis
williams - supravalvular AS
what are features of innocent murmurs ?
systolic murmur no other cardio signs soft murmur vibratory/musical localised
what is Still’s murmur ?
age 2-7
soft systolic vibratory, musical
apex, left sternal border
increased in supine and exercise
what is a pulmonary outflow murmur ?
age 8-10 soft systolic vibratory upper left sternal border, no radiationg increased in supine, exercise children w/ narrow chest
what are carotid/brachiocephalic arterial bruits ?
age 2-10 harsh systolic supraclavicular, radiates to neck increase exercise decrease turn/extend head
what is a venous hum ?
age 3-8 soft, indistinct continuous murmur, diastolic accentuation supraclavicular only in upright, disappears lying down
what are the 3 types of VSD ?
subaortic
perimembranous
muscular
what is the clinical presentation of VSD ?
pansystolic murmur
lower left sternal edge with thrill
what are clinical signs of ASD ?
wide fixed splitting of 2nd heart sound
pulmonary flow murmur
what are changes in the fetal circulation at brith ?
pulmonary vascular resistance falls
pulmonary blood flow rises
systemic vascular resistance increased
ductus arteriosus, foramen ovale, ductus venosus all close
how do you treat PDA ?
fluid restriction
diuretics
prostaglandin inhibitors - ibuprofen
surgical ligation
how do you manage aortic coarctation ?
reopen PDA with prostaglandin
resection
subclavian patch repair
balloon arthroplasty
