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Child Health > Paediatric Cardiology > Flashcards

Paediatric Cardiology Flashcards

1
Q

In the foetal circulation, is the resistance in the lungs high or low?

A

High

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2
Q

In the foetal circulation, is the resistance in the systemic circulation high or low?

A

Low

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3
Q

Oxygenated blood from the placenta travels to a foetus via what vessel?

A

The umbilical vein

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4
Q

Blood from the umbilical vein bypasses the liver as a result of what anatomical structure?

A

Ductus venosus

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5
Q

Blood from the umbilical vein drains into where?

A

IVC

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6
Q

In the foetal circulation, most blood from the IVC passes straight into the left atrium as a result of what anatomical structure?

A

Foramen ovale

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7
Q

In the foetal circulation, there is shunting of blood in what direction?

A

Right to left

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8
Q

In the foetal circulation, blood can pass from the pulmonary artery into the aorta as a result of what anatomical structure?

A

Ductus arteriosus

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9
Q

What happens to the pulmonary vascular resistance at birth?

A

It decreases

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10
Q

What happens to the systemic vascular resistance at birth?

A

It increases

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11
Q

Congenital heart disease is an umbrella term for abnormalities in the structure of the heart that develop when in embryogenesis?

A

Days 20-50

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12
Q

A high maternal alcohol consumption in pregnancy gives an increased risk of which congenital heart defects?

A

VSD and ASD

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13
Q

Maternal use of lithium in pregnancy increases the risk of what congenital heart defect in the foetus?

A

Ebstein’s anomaly

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14
Q

Apical displacement of tricuspid valve leaflets describes what congenital heart defect?

A

Ebstein’s anomaly

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15
Q

What congenital heart defects are likely to be seen in an individual with Turner’s syndrome?

A

Coarctation of the aorta and bicuspid aortic valves

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16
Q

Which congenital heart defects are likely to be seen in an individual with Down’s syndrome?

A

VSD or AVSD

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17
Q

There is an increased risk of which congenital heart disease in Down’s, Edward’s and Patau’s syndromes?

A

VSD

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18
Q

Name the acyanotic congenital heart defects which cause the formation of a left to right shunt?

A

ASD, VSD, AVSD and patent ductus arteriosus

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19
Q

Name the obstructive acyanotic congenital heart defects?

A

Aortic/pulmonary stenosis, coarctation of the aorta and hypoplastic left heart

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20
Q

Name the two cyanotic congenital heart defects?

A

Tetralogy of Fallot and transposition of the great arteries

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21
Q

What is the most common congenital heart defect?

A

VSD

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22
Q

In patent ductus arteriosus, blood is shunted from where to where?

A

Aorta to pulmonary artery

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23
Q

All babies with Down’s syndrome should undergo what investigation in the first few days of life to assess for congenital heart disease?

A

ECHO

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24
Q

A harsh pansystolic murmur heard best at the lower left sternal edge is heard in what congenital heart defect?

A

VSD

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25
Q

An ejection systolic murmur in the 2nd intercostal space is heard in what congenital heart defect?

A

ASD

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26
Q

A loud, low-pitched, continuous, machinery-like murmur is heard in what congenital heart defect?

A

Patent ductus arteriosus

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27
Q

Increased blood flow through the lungs as a result of a left-right shunt eventually leads to what irreversible complication?

A

Pulmonary hypertension

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28
Q

What is meant by Eisenmenger’s syndrome?

A

When pulmonary pressure becomes higher than systemic pressure (causing a left to right shunt to become a right to left shunt)

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29
Q

What investigation is used to confirm a diagnosis of congenital heart disease?

A

ECHO

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30
Q

What complication of congenital heart disease with a left to right shunt may be seen on an ECG?

A

Right ventricular hypertrophy

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31
Q

How are small congenital heart defects with a left to right shunt treated?

A

ECHO every 6-12 months (they will usually close spontaneously)

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32
Q

How are large congenital heart defects with a left to right shunt treated?

A

Surgical repair

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33
Q

How are babies with congenital heart disease fed, in order to promote their growth?

A

High calorie formula via an NG tube

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34
Q

Congenital aortic stenosis causes hypertrophy of which heart chamber?

A

Left ventricle

35
Q

Congenital pulmonary stenosis causes hypertrophy of which heart chamber?

A

Right ventricle

36
Q

Strenuous exercise should be avoided in children with which congenital heart defect?

A

Severe aortic stenosis

37
Q

Which obstructive congenital heart defects may present shortly after birth with a very unwell baby and no palpable femoral pulses?

A

Aortic stenosis or coarctation of the aorta

38
Q

What is the most common finding of a) aortic stenosis and b) pulmonary stenosis in older children?

A

a) syncope b) breathlessness

39
Q

A slow rising carotid pulse may be associated with which congenital heart defect?

A

Aortic stenosis

40
Q

An ejection systolic murmur, loudest of the aortic area and radiating to the carotids is most suggestive of which congenital heart defect?

A

Aortic stenosis

41
Q

What happens to the systolic BP in children with aortic stenosis?

A

It is low

42
Q

A wide split second heart sound may be associated with which congenital heart defect?

A

Pulmonary stenosis

43
Q

An ejection systolic murmur loudest over the pulmonary area is most suggestive of which congenital heart defect?

A

Pulmonary stenosis

44
Q

Weak femoral pulses and a radio-femoral delay are both signs of which congenital heart defect?

A

Coarctation of the aorta

45
Q

A pansystolic murmur in the left infraclavicular area radiating to the back is most suggestive of which congenital heart defect?

A

Coarctation of the aorta

46
Q

Rib notching on a CXR is most suggestive of which congenital heart defect?

A

Coarctation of the aorta

47
Q

What happens to the blood pressure of children with coarctation of the aorta?

A

Increased systolic BP in the upper body

48
Q

What are the treatment options for severe cases of pulmonary or aortic stenosis?

A

Ballon valvoplasty or open valvotomy

49
Q

How is coarctation of the aorta managed in neonates and infants?

A

Surgical resection

50
Q

How is coarctation of the aorta managed in older children?

A

Balloon dilatation

51
Q

What are the 4 features of Tetralogy of Fallot?

A

VSD, pulmonary stenosis, overriding aorta, right ventricular hypertropy

52
Q

In which type of cyanotic congenital heart disease are babies usually pink at birth, with cyanosis developing over the first few weeks of life?

A

Tetralogy of Fallot

53
Q

In which type of cyanotic congenital heart disease are babies cyanosed from birth?

A

Transposition of the great arteries

54
Q

What type of murmur will be heard in Tetralogy of Fallot?

A

Ejection systolic murmur over the pulmonary area

55
Q

In which type of cyanotic congenital heart disease is a murmur not heard?

A

Transposition of the great arteries

56
Q

A ‘boot shaped heart’ on CXR is suggestive of what congenital heart defect?

A

Tetralogy of Fallot

57
Q

An ‘egg-on-side’ appearance on CXR is suggestive of what congenital heart defect?

A

Transposition of the great arteries

58
Q

Digital clubbing is associated with what type of congenital heart disease?

A

Cyanotic congenital heart disease

59
Q

Should oxygen be given to babies with cyanotic congenital heart disease?

A

No

60
Q

How is Tetralogy of Fallot managed?

A

Surgical correction at 6-12 months

61
Q

How is transposition of the great arteries treated in the short term?

A

Prostaglandin infusion

62
Q

What is the definitive treatment for transposition of the great arteries?

A

Balloon septostomy followed by ‘arterial switch’ procedure

63
Q

What arrhythmia is most commonly encountered in paediatrics?

A

Supraventricular tachycardia

64
Q

All children with collapse should undergo what investigation to exclude an arrhythmia?

A

ECG

65
Q

What cardiac condition in children is caused by an accessory pathways between the atria and ventricles?

A

Wolff-Parkinson-White syndrome

66
Q

What is the characteristic ECG feature of Wolff-Parkinson-White syndrome?

A

Delta wave (slurred upstroke before the QRS)

67
Q

What happens to the PR interval in Wolff-Parkinson-White syndrome?

A

Shortened

68
Q

What is the first line management of SVT?

A

Vagal manoeuvres

69
Q

What is the second line management of SVT?

A

Rapid bolus of adenosine

70
Q

How are accessory pathways causing SVT that are resistant to medical treatment managed?

A

Radiofrequency ablation

71
Q

What are some anti-arrhythmic drugs that can be prescribed for children with recurrent SVTs?

A

Amiodarone or flecainide

72
Q

What cardiac infection is encountered most commonly in children?

A

Pericarditis

73
Q

The diagnosis of infective endocarditis is made on what investigation?

A

ECHO

74
Q

How is infective endocarditis treated?

A

IV antibiotics for at least 6 weeks

75
Q

Which arteries are particularly vulnerable in Kawasaki’s disease?

A

Coronary arteries

76
Q

Kawasaki’s disease most commonly affects children under what age?

A

5 years

77
Q

What diagnosis should be considered in any child presenting with more than 5 days of fever?

A

Kawasaki’s disease

78
Q

What is the most significant complication of Kawasaki’s disease?

A

Coronary artery aneurysms

79
Q

What is the most important investigation to perform in children with Kawasaki’s disease?

A

ECHO

80
Q

How is Kawasaki’s disease treated?

A

IV immunoglobulins and aspirin

81
Q

Acute rheumatic fever usually occurs around 2 weeks after what type of infection?

A

Group A beta haemolytic strep throat infection

82
Q

How is acute rheumatic fever treated?

A

Antibiotics and analgesia

83
Q

What investigation is used to diagnose cardiomyopathy?

A

ECHO

84
Q

How are children with cardiomyopathies managed?

A

ECHO every 3-6 months

Child Health (10 decks)

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