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Paediatrics > Paediatric Cardiology > Flashcards

Paediatric Cardiology Flashcards

1
Q

What are the commonly inherited paediatric heart diseases?

A

1 - Cardiomyopathy

2 - Long QT syndrome

3 - Marfan syndrome

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2
Q

What are the commonly acquired paediatric heart diseases?

A

Kawasaki

Rheumatic fever

Infective endocarditis

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3
Q

What is the main cardiovascular complication of Kawasaki disease?

A

Aneurysms of coronary arteries

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4
Q

What are the most common lesions accounting for 80% of congenital heart disease?

A

Ventricular Septal Defect

Patent Ductus Arteriosus

Atrial Septal Defect

Pulmonary stenosis

Aortic stenosis

Coarctation of the aorta

Transposition of great arteries

Tetralogy of Fallot

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5
Q

When do teratogenic insult to the fetus occur?

A

18-60 days post conception

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6
Q

What are the environmental factors that contribute to paediatric cardiac lesions?

A

1) Drugs
2) Infections
3) Maternal factors

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7
Q

What are common drugs that can cause paediatric cardiac lesions?

A

Alcohol

Amphetamines

Phenytoin

Lithium

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8
Q

What infections can cause paediatric cardiac lesions?

A

Toxoplasma

Rubella

CMV

Herpes

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9
Q

What are some maternal factors that can contribute to paediatriac cardiac lesions?

A

Diabetes Mellitus

SLE

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10
Q

What percentage of paediatric congenital heart disease cases have chromosomal problems?

A

6-10%

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11
Q

What are the most common chromosomal abnormalities observed in congenital heart disease and what are the proprotions for each?

A

Trisomy 13 (90%)

Trisomy 18 (80%)

Trisomy 21 (40%)

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12
Q

What are the most common cardiac lesions seen in Trisomy 13?

A

VSD

ASD

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13
Q

What are the most common cardiac lesions seen in Trisomy 18?

A

VSD

PDA

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14
Q

What are the most common cardiac lesions seen in Trisomy 21?

A

AVSD

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15
Q

What are other commonly observed genetic syndromes in patients with congenital heart conditions?

A

Turner syndrome

Noonan syndrome

Williams syndrome

22q11 deletion syndrome

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16
Q

With which physical defect is Turner syndrome associated?

A

Co-arctation of aorta

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17
Q

With which physical defect is Noonan syndrome associated?

A

Pulmonary stenosis

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18
Q

With which physical defect is Williams syndrome associated?

A

Supravalvular AS

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19
Q

What questions are important to ask in a paediatric patient you suspect of having a congenital heart condition?

A

1 - How is their feeding, weight and development?

2 - Signs of cyanosis

3 - Rapid breathing

4 - SOB

5 - Poor exercise tolerance

6 - Chest pain

20
Q

What features can be observed on examination of a child with a congenital heart defect?

A
  • Reduced weight and height
  • Cyanosis
  • Finger clubbing
  • Radio-femoral delay
  • Murmurs
21
Q

What investigations can be performed to help diagnose a congenital heart defect?

A

1 - O2 sats

2 - ECG

3 - Echocardiogram

4 - Exercise testing

5 - Angiogram

22
Q

What are the principles of treatment of paediatric heart defects?

A

1) Fix it
2) If it cant be fixed, use ballon valvo-plasty, shunt, prostaglandins etc.
3) Replace the defective structure

23
Q

What are the common harmless murmurs?

A

1 - Still’s murmur

2 - Pulmonary outflow murmur

3 - Carotid bruits

4 - Venous Hum

24
Q

What are the 3 main types of VSD’s?

A

1 - Subaortic

2 - Perimembranous

3 - Muscular

25
Q

What type of shunt occurs as a result of VSD’s?

A

Left to right shunt

26
Q

What else are VSD’s commonly known and why do they have this alternative name?

A

Acyanotic heart defect

Acyanotic because the blood is not by-passing the lungs as happens in right to left shunts

27
Q

How does a VSD present clinically?

A

1 - Pansystolic murmur on LLSE

2 - Tachycardia (sign of heart failure in children)

3 - Tachypnoea (sign of heart failure in children)

4 - Hepatomegaly (sign of heart failure in children)

28
Q

What are the long term complications of VSD?

A

1 - Ventricular hypertrophy

2 - Pulmonary hypertension

29
Q

What is eisenmenger syndrome?

A

The reversal of a L-R shunt into a R-L shunt resulting in cyanosis

30
Q

How can VSD’s be closed?

A

Amplatzer device

Patch closure

31
Q

What are the features of ASD’s?

A
  • Few clinical signs in early childhood
  • Often closes spontaneously
  • Sometimes detected in adulthood with AF
32
Q

With which Trisomy ar Atrioventricular-septal defects associated?

A

Trisomy 21

33
Q

What are the clinical features of pulmonary stenosis in children?

A

Ejection systolic murmur upper left sternal border with radiation to back

34
Q

What are the symptoms of a child with aortic stenosis?

A

Exercise intolerance

Exertional chest pain

Syncope

35
Q

What are features of an aortic stenosis murmur in children?

A

Ejection systolic murmur

Upper right sternal border

Radiates to carotids

36
Q

Which blood vessel supplies oxygenatedblood to the fetal heart?

A

Umbilical vein

37
Q

What changes occur in fetal circulation at birth?

A

1 - Pulmonary blood increases

2 - Systemic vascular resistance increases

3 - Ductus arteriosus closes

4 - Foramen Ovale closes

5 - Ductus Venosus closes

38
Q

In which group of infants is patent ductus arteriosus most common?

A

Pre-term infants

39
Q

What treatments can be given to help close a patent ductus arteriosus?

A

1 - Prostaglandin inhibitors

2 - Diuretics

40
Q

What is co-arctation of the aorta?

A

Kink in descending aorta wall

Kink is close to ductus arteriosus

41
Q

What are some clinical features of co-arctation of the aorta?

A

Radio-femoral delay

42
Q

How can co-arctation of the aorta be imaged?

A

Echocardiogram

MRI

43
Q

How are co-arctations of the aorta managed?

A

1 - Re-open PDA with prostaglandins

2 - Resect the coarcted part and anastamosis

3 - Ballon aortoplasty

44
Q

What happens in transposition of the great arteries?

A

Aorta connected to right ventricle

Pulmonary veins connected to left ventricle

No oxygenated blood being moved around body

45
Q

What are the clinical features of Fallot’s Tetralogy?

A

1 - Malposition of aorta

2 - Pulmonary stenosis

3 - Right ventricular hypertrophy

4 - VSD

Paediatrics (25 decks)

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