Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

EOY4 > Paediatric Cardiology > Flashcards

Paediatric Cardiology Flashcards

1
Q

Give 4 CYANOTIC congenital heart defects

A
  • Tetralogy of Fallot
  • Transposition of the Great Arteries
  • Tricuspid Atresia
  • Truncus Arteriosus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Give 4 ACYANOTIC congenital heart defects

A
  • Atrial Septal Defect
  • Ventricular Septal Defect
  • Patent Ductus Arteriosus
  • Coarctation of the Aorta
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

When does TOF normally present?

A

Usually around 1-2 months. It is the most common CHD except at birth which is TGA.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the 4 cardiac defects involved in ToF?

A
  • Pulmonary Stenosis (leads to) (functional due to overriding aorta)
  • Right ventricular hypertrophy
  • Ventricular Septal Defect
  • Overriding aorta (onto VSD)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the direction of the shunt in ToF and why?

A
  • Right to left
  • Pressure in RV > LV
  • Due to RV hypertrophy
  • Results in mixing of oxygenated and deoxygenated blood = cyanosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the cardiac presentations of ToF? (5)

A
  • Ejection systolic murmur @ upper left sternal border
  • Cyanosis +/- tet spells
  • Breathing difficulty
  • Clubbing at 1-2 months
  • Polycythaemia? Chronic hypoxia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is a tet spell?

A
  • Period of cyanosis upon exertion or anxiety etc
  • sudden marked increase in cyanosis followed by syncope
  • child may instinctively squat to ↑peripheral vascular resistance (↑pressure in femoral arteries) = ↑ pressure in LV to reverse the shunt
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Give 2 other, non-cardiac features of ToF

A
  • Difficulty feeding

- Not growing properly/failure to thrive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the investigations for ToF?

A
  • Echocardiogram + Doppler
  • CXR - has a boot shaped heart
  • Screen for DiGeorge Syndrome as conditions are often associated
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are 4 risk factors for ToF?

A

Non-modifable
- Maternal age >40

Modifiable

  • Maternal alcohol use during pregnancy
  • Maternal Diabetes
  • Maternal Rubella infection during pregnancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is transposition of the great arteries?

A
  • Pulmonary Artery and Aorta switch
  • Aorta now onto RIGHT VENTRICLE via pulmonary valve
  • Pulmonary artery now onto LEFT VENTRICLE via aortic valve
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How is TGA compatible with life?

A

Another heart defect, usually a VSD (or ASD or PDA) is present so that oxygenated and deoxygenated blood can mix

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How does TGA usually present?

A
  • At birth

- Initially ok but then presents as cyanosis that may rapidly deteriorate as the PDA closes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Give a risk factor for TGA

A

Maternal Diabetes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the immediate and long term management of TGA?

A
  • Immediate = give prostaglandins as will keep the ductus arteriosus open
  • Cardiac Repair Surgery
  • Arterial Switch
    May lead to:
    Arrhythmias
    Right ventricular hypertrophy
    Tricupsid Regurgitation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is tricuspid atresia?

A

Tricuspid valve is underdeveloped so doesn’t open/ is just some tissue.

Right Ventricle becomes hypoplastic too

RV is dysfunctional = ↓ blood to lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How is tricuspid atresia compatible with life?

A
  • An atrial septal defect AND a ventricular septal defect are both needed for compatibility with life:
  • ASD so that mixed blood can get into the LA to LV and onto the body
  • VSD so that blood can get from LV to RV and into the lungs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the cardiac presentations of tricuspid atresia?

A

Progressive cyanosis

Pansystolic murmur in mitral area (valve closed when LV contracts = turbulent flow)

Left Ventricular Hypertrophy (palpable apex beat?)

Tachypnoea for first 2 weeks of life

19
Q

What is the murmur associated with tricuspid atresia?

A

Pansystolic murmur in mitral area (valve closed when LV contracts = turbulent flow)

20
Q

What is the treatment for tricuspid atresia?

A

Treatment
Prostaglandins to keep PDA open
Cardiac repair surgery

21
Q

What is a ventricular septal defect?

A

There is a hole in the ventricular septum (usually the membranous part) allowing blood to flow from LEFT to RIGHT.

Forms a LEFT to RIGHT shunt as pressure is higher on the LEFT

22
Q

What could be a complication of a VSD?

A

↑ blood flow to lungs may lead to pulmonary hypertension and therefore pulmonary oedema etc. AND may reverse the shunt (Eisenmengers Syndrome)

23
Q

Which conditions are associated with a VSD?

A
  • Foetal alcohol syndrome

- Down’s Syndrome

24
Q

What are the symptoms of a VSD?

A
  • Often asymptomatic but depends on severity
  • Often ↓growth/ not growing as well as they should
  • If more severe then symptoms of heart failure
25
Q

What is the murmur associated with a VSD?

A
  • Pansystolic murmur at lower left sternal edge

- Thrill here

26
Q

What are the investigations for CHD?

A

Echocardiogram + doppler is diagnostic

27
Q

What is the treatment for a VSD?

A
  • Cardiac Repair Surgery between 3-6 months
  • ↑ calorie intake (growth bit)
  • Diuretics if HF
28
Q

What is an atrial septal defect?

What are the two types?

A
  • There is a gap in the septum between the atria
  • 2 kinds:
    - Secundum (more common) - involved Foramen Ovale
    - Atrioventricular Septal Defect - communication between atria at bottom of septum + abnormal valves
  • Blood is shunted from LEFT to RIGHT
29
Q

Is an ASD always pathological?

A

No

Opening within the septum is physiological in utero so that lungs can be bypassed

Oxygenated blood is received from the placenta via the umbilical vein →RA →LA →LV →Body

Foramen Ovale should close at birth

30
Q

Which conditions are associated with ASDs?

A
  • Foetal Alcohol Syndrome

- Down’s Syndrome

31
Q

What is a potential complication of an ASD?

A
  • Paradoxical embolism
  • Embolism returns to R heart and moves into L
  • Can potentially travel to the brain and cause a stroke etc
32
Q

What is the murmur associated with an ASD?

A
  • Ejection Systolic murmur at upper left sternal border
  • Partial AVSD may also have a pansystolic murmur at the apex
  • S2 heart sound splits
33
Q

What are the symptoms of an ASD?

A

Most often is asymptomatic but can have recurrent chest infections

34
Q

What are the treatment options for an ASD?

A

Occlusion Device

Cardiac Repair Surgery

35
Q

What is the function of the ductus arteriosus?

A

Connects the pulmonary artery to the descending aorta in utero

Normally closes after birth if born at term

Blood can flow from aorta into pulmonary artery and to lungs so ↑ pulmonary blood flow

36
Q

When is the ductus arteriosus counted as PATENT?

A

If it hasn’t closed one week after the estimated date of delivery

37
Q

What are the symptoms of a PDA?

A

often asymptomatic but may have symptoms of RIGHT heart failure

38
Q

What is the murmur associated with a PDA?

A

Continuous machinery murmur under the LEFT clavicle

Bounding pulse

39
Q

What is the role of echo + doppler in PDA?

A
  • Diagnosis

- Rules out duct dependent circulation before closure of the defect

40
Q

How can a PDA be closed?

A
  • Ibuprofen or endovascular surgery before 1 year old
41
Q

Why is a PDA therapeutically closed?

A
  • Close the duct to ↓risk of bacterial endocarditis/pulmonary vascular disease in later life
42
Q

What is Ebstein’s Anomaly?

A

CHD due to the use of Lithium during pregnancy

43
Q

What is the pathophysiology of Ebstein’s Anomaly?

A

Posterior leaflets of the tricuspid valve become anteriorly displaces towards the apex

causes tricuspid regurgitation AND tricuspid stenosis

AND right atrium enlargement

44
Q

What are the murmurs associated with Ebstein’s anomaly?

A
  • Pansystolic @ upper left sternal edge (tricuspid regurgitation)
  • mid diastolic (tricuspid stenosis)

EOY4 (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions