paediatric cardiology Flashcards
What does raised JVP suggest
Right heart failure
What is a innocent murmur
Noise that can be heard as blood passes through a normal heart
Describe the characteristics of a innocent murmur
- Soft 1-2/6
- Systolic
- Varies with posture
- No thrill
- Short duration
- Asymptomatic apart from murmur
Describe Stills murmur
- School age children
- Best heard in the left lower sternal edge
- Systolic murmur
- Decreases when standing up
Describe physiological pulmonary stenosis
- Newborns (3-6 months)
- Localised to left upper sternal edge
- Systolic murmur
Describe cervical venous hum
- Sound of blood flowing to the heart in veins
- Young school age
- Heard only when sitting up right
- Anterior neck to infraclavicular area R>L
- Continuous soft murmur
Describe pulmonary flow murmur
- Older children and teenagers
- Thin chest walls
- Normal blood flow through pulmonary valve which is quite close to the chest
- Ledt upper sternal edge
- Systolic
What is the presentation of pulmonary stenosis
- Asymptomatic in mild stenosis
- Exertional Dyspnoea and fatigue in moderate and severe
Describe the murmur associated with pulmonary stenosis
Ejection systolic murmur in the upper left sternal border with radiation to the back
What is the presentation of aortic stenosis
- Asymptomatic
- If severe, reduced exercise tolerance, exertional chest pain and and syncope
Describe the murmur associated with aortic stenosis
Ejection systolic murmur - upper right sternal border - radiates to the carotids
What is the treatment for a patent ductus arteriosus
- Fluid restriction or diuretics
- Ibuprofen and indomethacin
- Surgical ligation
What is a coarction of the aorta
Narrowing of an area in the aorta
What is the presentation of coarctation of the aorta
- Weak or absent femoral pulse
- Radio-femoral delay
- Harsh Systolic murmur which is loudest on the back
- Sudden deterioration and collapse
What is the management of coarctation of the aorta
- Reopen the patent ductus arteriosus with prostaglandin E1 or 2
- Resection with end to end anastamosis
- Subclavian patch repair
- Balloon aortoplasty
What is transposition of the great arteries
The pulmonary arteries are connected to the left ventricle and the aorta is connected to the right ventricle which is the wrong side
What is the management for transposition of the great arteries
- Prostaglandins to keep the ductus arteriosus open
- Switch procedure
What conditions cause cyanosis
- Transposition of the great arteries
- Tetralogy of Fallot
What are the 4 abnormalities in tetralogy of Fallot
- Narrowing of the right ventricular outflow tract
- Pulmonary valve stenosis
- Ventricular septum defect
- Over riding aorta (sticks out into the ventricle)
What is the management for tetralogy of fallot
- Beta blockers for symptomatic aid
- Full correction at 5kg
