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Year 3 > Paediatric Cardiology > Flashcards

Paediatric Cardiology Flashcards

1
Q

8 common causes of congenital heart disease

A
  1. Ventricular septal defect (VSD)
  2. Patent ductus arteriosus (PDA)
  3. Atrial septal defect (ASD)
  4. Pulmonary stenosis
  5. Aortic stenosis
  6. Coarctation of the aorta
  7. Transposition of the great arteries
  8. Tetralogy of Fallot
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2
Q

types of paediatric heart disease

A

• Congenital heart defects
• Screening and monitoring inherited disease; cardiomyopathy, long QT syndrome, Marfan
syndrome etc.
• Acquired disease : Kawasaki, Rheumatic Fever, bacterial Endocarditis
• Arrhythmias, mainly SVT

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3
Q

teratogenic drugs

A 
o Alcohol
o Amphetamines
o Cocaine
o Ecstasy
o Phenytoin
lithium
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4
Q

teratogenic infection

A

TORCH

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5
Q

materal causes of teratogenesis

A

DM

SLE

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6
Q

chromosomal disorders and their defects: trisomy 13

A

90%

VSD and ASD

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7
Q

chromosomal disorders and their defects: trisomy 18

A

80%

VSD and PDA

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8
Q

chromosomal disorders and their defects: trisomy 21

A

40%

AVSD

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9
Q

chromosomal disorders and their defects: turner

A

co-arctation of aorta

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10
Q

chromosomal disorders and their defects: noonan

A

pulmonary stenosis

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11
Q

chromosomal disorders and their defects: williams

A

supravalvular AS

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12
Q

history in paeds cardiology

A
  • Feeding, Weight and Development
  • Cyanosis
  • Tachypnoea, Dyspnoea
  • Exercise Tolerance
  • Chest Pain
  • Syncope
  • Palpitation
  • Joint Problems
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13
Q

examination in paeds cardiology

A
  • Weight and Height
  • Dysmorphic features
  • Cyanosis
  • Clubbing
  • Tachy-/Dyspnoea
  • Pulses/Apex (femoral pulses!)
  • Heart Sounds (clicks, split, 3rd and 4th)
  • Murmurs
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14
Q

investigations in paeds cardiology

A
  • Blood Pressure
  • O2 saturation, arterial BGA
  • ECG (12 lead, 24hrs, event monitor)
  • CXR
  • Echocardiogram
  • Catheter
  • Angiography
  • MRI/A
  • Exercise testing (ECG, sO2)
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15
Q

treatment principles in paeds cardiology

A 
• If you can fix it -> fix it
• If you can’t fix it -> improve the situation : - medication
o Palliative procedure, e.g.
o BT shunt, balloon valvoo
Plasty, Prostaglandin
o Infusion, pulmonary
o Banding
• If you can do neither ->replace it
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16
Q

characterisation of murmurs

A 
• Timing in Cardiac Cycle
o Systole / Diastole / Continuous
• Duration
o Early / Mid / Late
o Ejection / Holo or Pan Systolic
• Pitch / Quality
o Harsh or Mixed Frequency (Turbulence)
o Soft or Indeterminate
o Vibratory / Pure Frequency (Laminar Flow)
17
Q

common features of the innocent murmurs

A
  • Systolic murmur (continuous in venous hum)
  • No other signs of cardiac disease
  • Soft murmur, grade 1/6 or 2/6
  • Vibratory, musical
  • Localised
  • Varies with position, respiration, exercise
18
Q

name the innocent murmurs

A

Stills - LV outflow murmur
Pulmonary outflow murmur
carotid/brachiocephalic arterial bruits
venous hum

19
Q

Still’s murmur

A
  • Age 2-7 years
  • Soft systolic; vibratory, musical, ”twangy”
  • Apex, left sternal border
  • Increases in supine position and with exercise
20
Q

Pulmonary outflow murmur

A
  • Age 8-10 years
  • Soft systolic; vibratory
  • Upper left sternal border, well localised, not radiating to back
  • Increases in supine position, with exercise
  • Often children with narrow chest
21
Q

carotid/brachiocephalic arterial bruits

A
  • Age 2-10 years
  • 1/6-2/6 systolic; harsh
  • Supraclavicular, radiates to neck
  • Increases with exercise, decreases on turning head or extending neck
22
Q

venous hum

A
  • Age 3-8 years
  • Soft, indistinct
  • Continuous murmur, sometimes with diastolic accentuation
  • Supraclavicular
  • Only in upright position, disappears on lying down or when turning head
23
Q

types of VSD

A

subaortic
perimembranous
muscular

24
Q

shunt in VSD

A

L to R

25
Q

clinical presentation of VSD

A

• Pansystolic murmur lower left sternal edge,
sometimes with thrill
• In very small VSDs, early systolic murmur
• In very large VSDs diastolic rumble due to relative
mitral stenosis
• Signs of cardiac failure in large VSDs, eventually
leading to biventricular hypertrophy and pulmonary
hypertension

26
Q

ASD deatures

A

There are few clinical signs of these in early childhood, with a good chance of spontaneous closure.
They are sometimes detected in adulthood with atrial fibrillation, heart failure or pulmonary
hypertension. Wide fixed splitting of 2nd heart sound, pulmonary flow murmur.

27
Q

AVSD

A

associated with trisomy 21

AV valve with ostium primum ASD and high VSD

28
Q

pulmonary stenosis features

A

Pulmonary stenosis is asymptomatic when its mild. In moderate and severe stenosis patients have
exertional dyspnoea and fatigue. Ejection systolic murmur upper left sternal border with radiation to
back.

29
Q

aortic stenosis features

A

This is mostly asymptomatic. If severe there is reduced exercise tolerance, exertional chest pain and
syncope. Ejection systolic murmur in upper right sternal border, radiation into carotids

30
Q

changes in the 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
31
Q

patient ductus arteriosus management

A

Very common in pre-term infants, treatment with fluid restriction/diuretics, prostaglandin inhibitors
(Indomethacin, Ibuprofen), surgical ligation. In term babies good chance of spontaneous closure, not
prostaglandin sensitive.

32
Q

management of coarctation of the aorta

A
  • Re-open PDA with Prostaglandin E1 or E2
  • Resection with end-to-end anastomosis
  • Subclavian patch repair
  • Balloon Aortoplasty
33
Q

tetralogy of fallot

A

over riding aorta
VSD
pulmonary stenosis
RV hypertrophy

Year 3 (164 decks)

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