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Year 4 Paediatrics > Paediatric Cardiology > Flashcards

Paediatric Cardiology Flashcards

1
Q

Cyanotic heart conditions

A

Transposition of the Great arteries
Total Anomalous Pulmonary Venous drainage
Tricuspid atresia
Tetralogy of Fallot - if extensive pulmonary stenosis

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2
Q

Acyanotic heart conditions

A

Left to right shunts - ASD, VSD, PDA

Obstruction - Aortic, mitral or pulmonary stenosis, coarctation of the aorta

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3
Q

Treatment for patent ductus arteriosus

A

Indomethacin to neonate

Trans-catheter or surgical closure

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4
Q

Murmur for patent ductus arteriosus

A

Machine-like murmur

Continous

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5
Q

Tetrology of Fallot features

A

Pulmonary stenosis
Right ventricle hypertrophy
Overriding aorta
Ventricular septal defect

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6
Q

Murmur for Tetrology of Fallot

A

Pansystolic murmur

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7
Q

Aortic stenosis presentation

A

Fainting and dizziness
Chest pain on exertion - angina
Fatigue

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8
Q

Murmur for aortic stenosis

A

Ejection systolic -
second intercostal space, right sternal border
Carotid bruit

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9
Q

Treatment for aortic stenosis

A

Valve replacement

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10
Q

Murmur for pulmonary stenosis

A

Pansystolic murmur

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11
Q

Murmur for pulmonary stenosis

A

Pansystolic murmur - second intercostal space, left sternal border)

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12
Q

Transposition of the great arteries presentation

A

Cyanosis
Poor feeding
Poor weight gain - failure to thrive
Respiratory distress

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13
Q

Transposition of the great arteries murmur

A

No murmur

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14
Q

Transposition of the great arteries treatment

A

Prostin
Create a ASD
Arterial switch surgery

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15
Q

Tetrology of Fallot treatment

A

Prostin

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16
Q

Tetrology of Fallot treatment

A

Prostin

Fontan surgery

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17
Q

Innocent murmurs pathophysiology

A

Flow murmurs in children, caused by fast blood flow during systole

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18
Q

Innocent murmurs features

A 
Soft
Short
Systolic
Symptomless
Situation dependent - changes with posture
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19
Q

When to refer an innocent murmurs

A

Murmur louder than 2/6
Diastolic murmurs
Louder on standing
Other symptoms - failure to thrive, feeding difficulty, cyanosis or shortness of breath

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20
Q

Investigations for murmurs

A

ECG
Chest Xray
Echocardiography

21
Q

When does the ductus arteriosus normally close?

A

Stops functioning at 1-3 days of birth, and closes completely within the first 2-3 weeks of life

22
Q

Risk factors for PDA

A

Prematurity

Rubella

23
Q

Presentation of PDA

A

May be asymptomatic

Shortness of breath
Difficulty feeding
Poor weight gain
Lower respiratory tract infections

24
Q

Risk factors for Tetrology of Fallot

A

Rubella infection
Increased age of the mother (40 + years)
Alcohol during pregnancy
Diabetic mother

25
Q

Investigations for Tetrology of Fallot

A

Echocardiogram
Doppler flow studies
Chest Xray - boot shaped

26
Q

Signs and Symptoms of Tetrology of Fallot

A 
Cyanosis
Clubbing
Poor feeding
Poor weight gain
Ejection systolic murmur heard loudest in the pulmonary area
“Tet spells”
27
Q

“Tet spells”

A

Transient cyanotic episode

Caused by pulmonary vascular > systemic resistance

  • e.g. exercise due to vasodilation
28
Q

Treatment of tet spells

A

Older children may squat when a tet spell occurs.

Younger children can be positioned with their knees to their chest

Medical:
Oygen
Beta blockers
IV fluids
Morphine - decrease respiratory drive
Sodium bicarbonate can buffer metabolic acidosis
Phenylephrine infusion - increase systemic vascular resistance

29
Q

Atrial septal defect presentation

A

SOB
Difficulty feeding
Poor weight gain
Lower respiratory tract infections

30
Q

Eisenmenger syndrome

A

Pulmonary pressure > systemic pressure

Shunt reverses and forms a right to left shunt

Due to right sided hypertrophy

31
Q

Complications of atrial septal defects

A

Stroke - VTE
AF or atrial flutter
Pulmonary hypertension and right sided HF
Eisenmenger syndrome

32
Q

Atrial septal defect murmur

A

Mid-systolic, crescendo-decrescendo murmur

Fixed split second heart sound (S2) - increased blood flow via the pulmonary artery therefore closure of pulmonary and aortic valves is not in-sync

33
Q

Conditions associated with ventricular septal defects

A

Down’s syndrome

Turner’s syndrome

34
Q

Presentation of ventricular septal defects

A

Right sided heart failure:

Failure to thrive 
Poor feeding 
SOB 
Recurrent respiratory tract infections
Hepatomegaly
35
Q

Murmur for a ventricular septal defect

A

Pan systolic murmur at left lower sternal border

May have systolic thrill

36
Q

Causes of Eisenmenger syndrome

A

Atrial septal defect
Ventricular septal defect
Patent ductus arteriosus

37
Q

Signs or Eisenmengers syndrome

A 
Raised JVP 
Hepatomegaly 
Right ventricular heave 
Loud P2 
Peripheral oedema 
Pulmonary oedema - crackles

Hypoxia:
Cyanosis
Clubbing
Plethoric complection - polycythaemia

38
Q

Management of Eisenmengers syndrome

A
  • impossible to medically reverse condition

Supportive:

  • oxygen
  • venesection for polycythaemia
  • anticoagulants - aspirin
  • prophylaxtic abx - prevent infective endocarditis
  • sildenafil - pulmonary hypertension
39
Q

Coarctation of the aorta pathophysiology

A

Narrowing of the aortic arch around the ductus arteriosus

40
Q

Condition associated with coarctation of the aorta

A

Turners syndrome

41
Q

Presentation of coarctation of the aorta

A
  • Abscent femoral pulses or radial - femoral delay
  • unequal four limb blood pressure - higher in right arm
  • systolic murmur
  • left ventricular heave
  • underdevelopment of left arm and lower limbs
  • tachypnoea
  • poor feeding
  • grey and floppy baby
42
Q

Signs of aortic stenosis

A

Thrill
Ejection click
Slow rising pulse and narrow pulse pressure

43
Q

Complications of aortic stenosis

A

Left sided heart failure
Ventricular arrythmia
Bacterial endocarditis
Sudden death

44
Q

Conditions associated with pulmonary stenosis

A

Tetralogy of Fallot
William syndrome
Noonan syndrome
Rubella

45
Q

Presentation of pulmonary stenosis

A

Poor feeding
Failure to thrive
Fatigue on exertion
SOB

46
Q

Signs of pulmonary stenosis

A

Ejection systolic murmur
Palpable thrill
Right ventricular heave
Raised JVP

47
Q

Ebstein’s anomaly pathophysiology

A

The tricuspid valve is set lower in the right side of the heart so the right atrium is bigger than the right ventricle

Often associated with a ASD
Often right to left shunt

48
Q

Ebstein’s anomaly presentation

A 
Heart failure - oedema 
Gallop rythmn 
Cyanosis 
SOB 
Poor feeding 
Collapse or cardiac arrest
49
Q

Pathophysiology of transposition of the great arteries

A

Aorta carries deoxygenated blood to the body from the right ventricle

Pulmonary artery carries oxygenated blood to the lungs via the left ventricle

Associated with a septal defect

Year 4 Paediatrics (19 decks)

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