Paediatric Cardiology Flashcards

1
Q

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?

A
  1. Cyanotic CHD: TOF, TGA, tricuspid or pulmonary atresia
  2. Respiratory: RDS, meconium aspiration, pulmonary hypoplasia
  3. Sepsis: GBS or other organisms
  4. Inborn errors of metabolism (causing metabolic acidosis and shock)
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2
Q

Name 4 features of heart failure in children.

A
  1. SOB and sweating on exertion/feeding
  2. poor feeding
  3. recurrent chest infections
  4. failure to thrive
  5. tachypnoea and tachycardia
  6. heart murmur, gallop rhythm
  7. hepatomegaly
  8. cool peripheries
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3
Q

A neonate presents with features of HF. What is your differential diagnosis? What if this was an infant? An adolescent?

A

Neonate - obstructed (duct-dependent) systemic circulation:

  1. hypoplastic L heart syndrome
  2. severe coarctation of the aorta
  3. interruption of the aortic arch
  4. 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:

  1. VSD
  2. ASD
  3. large PDA

Adolescent (R or L heart failure):

  1. Eisenmenger syndrome (R heart failure only)
  2. rheumatic heart disease or viral myocarditis
  3. cardiomyopathy
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4
Q

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?

A

Prostaglandin infusion

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5
Q

How would you manage a 5 week old with failure to thrive, who is diagnosed with a moderate VSD?

A

Medical management

  1. diuretics e.g. furosemide (to decrease preload and improve pulmonary oedema)
  2. ACEi e.g. captopril (to reduce afterload)
  3. +/- digoxin (to increase contractility)
  4. NG feed
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