Paediatric Cardiology Flashcards
What are the symptoms typically associated with poor tissue perfusion in heart failure?
Generally non-specific:
- fatigue
- poor exercise tolerance
- confusion
What are the symptoms of congestion of the system in heart failure?
Generally more specific:
- Dyspnoea
- Hepatomegaly
Name a condition which causes heart failure by increased afterload.
Coarctation of aorta (CoA)
Name a condition which causes heart failure by increased preload.
Ventricular Septal Defect (VSD)
Which causes of heart failure usually present within the first few days of life?
CoA
Hypoplastic Left-Side of Heart
Other than conditions with increased preload or afterload, what other processes can heart failure occur?
Tachyarrhythmias
Myocardial abnormalities
Infection
Cardiomyopathy
What are the chest signs of cardiac failure?
SOB Tachypnoea Cough Lung Creps Cardiomegaly Tachycardia/ 'gallop' heart rythym
What are the GI signs of heart failure?
Poor feeding
Poor weight gain
Failure to thrive (FTT)
Hepatomegaly
Other than chest and GI symptoms, how else can heart failure present?
Sweating
Fatigue
Confusion
In terms of clinical signs of heart failure which major group of signs present in adults, tends to be absent in children?
Those of congestive heart failure:
- peripheral oedema
- PND
- Elevated JVP
What may a CXR show in heart failure?
Cardiomegaly
Oedema
What may an ABG show in heart failure
Low PO2
Metabolic acidosis
In suspected heart failure how should Sp02 be tested in babies?
Pre-ductal compared to post ductal
Where can pre-ductal SP02 be measured?
Right arm/hand only
What investigations should be done for presumed heart failure?
ECG Echo SPO2 ABG Serum electrolytes CXR
Why should O2 be given cautiously in Left to Right shunting?
Pulmonary vasodilation may increase shunting
What are the general measures of management of heart failure?
Overall - diagnose and treat underlying cause! Oxygen Diuretics Diet (higher calorie if FTT) ACEIs Respiratory and/or cardiac (BP) support
What is the likely cause of an ejection systolic murmur heart heard loudest over the upper right sternal edge which radiates to the neck?
Aortic Stenosis
What type of murmur does Pulmonary stenosis cause?
Ejection systolic, heard loudest at upper left sternal edge +/- thrill which radiates to the back
What is the cause of a continuous machinery-like murmur heard loudest over left clavicular area and radiates to the back?
PDA
What type of murmur does VSD cause?
Loud pansystolic murmur heard loudest at lower left sternal edge and radiates to axilla. May cause a parasternal thrill.
Which murmurs tend to be diastolic?
Aortic regurgitation
Pulmonary regurgitation
Mitral stenosis
Tricuspid stenosis
Which long systolic murmur is heard best at the apex and may radiate to the axilla?
Mitral regurgutation
What condition causes a ejection systolic murmur heard loudest at upper left sternal edge, and has a split fixed S2?
ASD secundum
What type of murmur does partial AVSD cause?
Ejection systolic murmur heart loudest at upper left sternal edge with a fixed split S2 and an apical pansystolic murmur
Which condition causes an ejection systolic murmur loudest at the upper left sternal edge, radiates to the back with weak/absent pulses in a neonate?
Coarctation of Aorta
What murmur does tetralogy of fallot cause?
Long systolic murmur over mid-left sternal edge with single S2. Associated with cyanosis.
Is a diastolic murmur innocent or pathological?
Pathological
Is a murmur which intensifies with increased cardiac output innocent or pathological?
Innocent
Is a murmur which radiates innocent or pathological?
Pathological
