Paediatric Cardiology Flashcards
You are called to see a 1 day old neonate who developed central cyanosis (mum had not had any antenatal care) and shock. What is your differential diagnosis?
- Cyanotic CHD: TOF, TGA, tricuspid or pulmonary atresia
- Respiratory: RDS, meconium aspiration, pulmonary hypoplasia
- Sepsis: GBS or other organisms
- Inborn errors of metabolism (causing metabolic acidosis and shock)
Name 4 features of heart failure in children.
- SOB and sweating on exertion/feeding
- poor feeding
- recurrent chest infections
- failure to thrive
- tachypnoea and tachycardia
- heart murmur, gallop rhythm
- hepatomegaly
- cool peripheries
A neonate presents with features of HF. What is your differential diagnosis? What if this was an infant? An adolescent?
Neonate - obstructed (duct-dependent) systemic circulation:
- hypoplastic L heart syndrome
- severe coarctation of the aorta
- interruption of the aortic arch
- critical aortic valve stenosis
Infant - L to R shunt presenting in weeks following birth as pulmonary vascular resistance falls causing increase in L to R shunt and increased pulmonary oedema and SOB:
- VSD
- ASD
- large PDA
Adolescent (R or L heart failure):
- Eisenmenger syndrome (R heart failure only)
- rheumatic heart disease or viral myocarditis
- cardiomyopathy
A 2 day old neonate is cyanosed and in shock. He is diagnosed with severe coarctation of the aorta. How would you manage him acutely?
Prostaglandin infusion
How would you manage a 5 week old with failure to thrive, who is diagnosed with a moderate VSD?
Medical management
- diuretics e.g. furosemide (to decrease preload and improve pulmonary oedema)
- ACEi e.g. captopril (to reduce afterload)
- +/- digoxin (to increase contractility)
- NG feed