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Paediatrics > Paediatric Cardiology > Flashcards

Paediatric Cardiology Flashcards

1
Q

What environmental factors can cause paediatric cardiac problems?

A

Alcohol
Drugs (amphetamines, cocaine, ecstasy, phenytoin, lithium)
Infections (toxoplasma, rubella, CMV, herpes)
Maternal diabetes
Maternal SLE

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2
Q

What chromosomal abnormalities are linked to paediatric cardiac problems?

A

Trisomy 13
Trisomy 18
Trisomy 21

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3
Q

What cardiac problems can occur in Turner syndrome?

A

Co-arctation of aorta

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4
Q

What cardiac problems can occur in Noonan syndrome?

A

Pulmonary stenosis

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5
Q

What cardiac problems can occur in Williams syndrome?

A

Supravalvular AS

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6
Q

What are common indicators of cardiac problems from taking a history?

A 
Feeding, Weight and Development
Cyanosis
Tachypnoea, Dyspnoea
Exercise Tolerance
Chest Pain
Syncope
Palpitation
Joint Problems
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7
Q

What are common indicators of cardiac problems from examination?

A 
Weight and Height
Dysmorphic features
Cyanosis
Clubbing
Tachy-/Dyspnoea
Pulses/Apex
Heart Sounds (clicks, split, 3rd and 4th)
Murmurs
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8
Q

What investigations should be done fro cardiac problems?

A 
Blood Pressure
O2 saturation, arterial BGA
ECG (12 lead, 24hrs, event monitor)
CXR
Echocardiogram
Catheter
Angiography
MRI
Exercise testing (ECG, sO2)
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9
Q

How are murmurs characterised?

A

Timing in cardiac cycle
Duration
Pitch/quality

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10
Q

What are common features of murmurs?

A 
No other signs of cardiac disease 
Soft murmur, grade 1/6 or 2/6 
Vibratory, musical 
Localised
Varies with position, respiration, exercise
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11
Q

What are the features of Still’s murmur (LV outflow murmur)?

A

Soft systolic, vibratory, musical, “twangy”
Apex, left sternal border
Increases in supine position and with exercise

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12
Q

What are the features of a pulmonary outflow murmur?

A 
Soft systolic, vibratory 
Upper left sternal border 
Well localised 
Increases in supine position and with exercise 
Often children with narrow chest
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13
Q

What are the features of a carotid arterial bruit?

A

1/6-2/6 systolic, harsh
Supraclavicular, radiates to neck
Increases with exercise, decreases on turning head or extending neck

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14
Q

What are the features of a venous hum?

A

Soft, indistinct
Continuous murmur, sometimes its diastolic accentuation
Supraclavicular
Only in upright position, disappears on lying down or when turning head

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15
Q

What are the 3 main types of ventricular septal defects?

A

Subaortic
Perimembranous
Muscular

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16
Q

What is the clinical presentation of a ventricular septal defect?

A

Pansystolic murmur lower left sternal edge, sometimes with thrill
Early systolic murmur
Diastolic rumble due to relative mitral stenosis
Signs of cardiac failure, leading to biventricular hypertrophy and pulmonary hypertension

17
Q

How are ventricular septal defects closed?

A

Amplatzer device

Patch closure

18
Q

What are the features of atrial septal defects?

A

Wide fixed splitting of 2nd heart sound, pulmonary flow murmur

19
Q

What cardiac problem is trisomy 21 associated with?

A

Antrioventricular-septal defect or endocardial cushion defect

20
Q

What is atrioventricular-septal defect?

A

Singular AV valve with ostium primum ASD and high VSD

21
Q

What are the clinical features of pulmonary stenosis?

A

Severe exceptional dyspnoea and fatigue

Ejection systolic murmur upper left sternal border with radiation to back

22
Q

What are the clinical features of aortic stenosis?

A

Reduced exercise tolerance
Exceptional chest pain
Syncope
Ejection systolic murmur upper right sternal border, radiation into carotids

23
Q

What are the changes in foetal circulation at birth?

A 
Pulmonary Vascular Resistance Falls
Pulmonary Blood Flow Rises
Systemic Vascular Resistance is Increased
Ductus Arteriosus Closes
Foramen Ovale Closes
Ductus Venosus Closes
24
Q

What is the treatment for patent ductus arteriosus?

A

Fluid restriction
Diuretics
Prostaglandin inhibitors
Surgical ligation

25
Q

What is the management for coarctation of the aorta?

A

Re-open PDA with prostaglandin E1 or E2
Resection with end to end anastomosis
Subclavian patch repair
Balloon aortoplasty

Paediatrics (20 decks)

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