Paediatrics Cardiology Flashcards
What congenital heart defect is Down’s syndrome associated with?
Ventricular Septal Defect
very - v- resiliant
What congenital heart defect are patients with Turner’s Syndrome associated with?
Coarction of the aorta (descending aorta usually effected)
What type of aneurism are children with Kawasaki at risk of?
coronary artery aneurism
‘cyanosis’ in the newborn is a buzzword for?
congenital heart defect
How do you differentiate between 1st and 2nd heart sound?
feel the pulse at the same time
What is the ‘foramen oval’ its purpose and when does it close?
Theforamen ovaleis a hole in the wall between the left and right atria of every human fetus. It allows blood to bypass the fetal lungs, which cannot work until air is inhaled after birth
-therefore foramen ovale is present in babies not been born yet!
What is the name of the condition if the ‘foramen ovale’ fails to close at birth?
Atrial Septal Defect
(*as foramen ovale between right and left atria)
What is ductus arteriosus?
This is a shunt between the pulmonary artery and aorta allowing for it to bypass the foetal lungs. This is held open due to the rise in Prostoglandin E2.
Shunt closed when baby is born and prostaglandin levels drop
What is the name of the shunt which bypasses the foetal lungs and connects the pulmonary artery to the aorta?
ductus arteriosus- between the pulmonary arteries and aorta
What is the role of E2 prostaglandin in Patent Ductus Arteriosus?
-high levels during foetal life, levels drop when baby is born allowing for shunt to close
ductus arteriosus- shunt between pulmonary arteries and aorta
“machine like murmur” is associated with?
patent ductus arteriosus
make PAint in machine
What congenital heart condition has normal S1 and abnormal S2
patent ductus arteriosus
What is the management of Patent Ductus Arteriosus?
b) what is the purpose of this medication
1st line- indomethacin, NSAIDs or paracetamol
-blocks the E2 prostaglandin synthesis and makes the shunt close
What is the mechanism of atrial septal defects?
This is when there is a defect between the right and left atria in the heart. Therefore allowing for blood to flow between them.
‘crescendo-decrescendo murmur loudest at the upper left sternal border’ is associated with what heart defect?
Atrial Septal Defect- crescendo- top- atria
What is the diagnostic investigation for most Congenital Cardiac Defects in paediatrics?
(e.g ASD, Patent Ductus arteries and Tetralogy of Fallot etc)
Diagnostic Investigation:
1st line- echocardiogram
What is Ventricular Septal Defect?
This is a congenital hole in the septum between the left and right ventricles. Blood flows from the left to the right ventricle because the pressure is higher in the left.
(left > right shunt formed
What are the x2 heart murmurs which can cause a ‘pan-systolic murmur?’
Mitral regurgitation and tricuspid regurgitation
What congenital condition is a ‘pan systolic murmur associated with’
pan- cook -venison
Ventricular Septal Defect
What genetic condition is associated with coarction of the aorta?
Turner’s syndrome
What is correction of the aorta?
b) does it effect ascending or descending aorta
nition:
This refers to a congenital narrowing of the descending aorta.
What are the X4 conditions associated with the Tetralogy of Fallot?
(POVR)
X4 Congenital Conditions:
- Pulmonary Stenosis
- Over-Riding Aorta
- Ventricular Septal Defect
- Right ventricular hypertrophy
What side-side of the heart does blood flow
left > right as left side is stronger
‘boot shaped heart’ on CXR is associated with?
Tetralogy of Fallot
What is the management of tetralogy of fallot?
b) what is the management of cyanotic episodes?
Management:
1st line- E2 prostoglandin infusion (do not want it to shut as we need the blood flow)
Cyanotic Episodes:
1st line- beta blockers may help with the infundibular spasm
What congenital defect is associated with mother taking these medications during pregnancy?
-NSAIDs
-lithium
-phenytoin
-sodium valproate or methotrexate
-NSAIDs (*mainly 1st trimester)-congenital heart defects as blocks prostaglandin synthesis
-lithium- Ebstein’s anomaly
-phenytoin- cleft palate
-sodium valporate- neural tube defects (e.g spina bifida)
What is Ebstein’s Anomaly, and what valve is it associated with?
This is a congenital heart condition where the tricuspid valve is set lower in the right side of the heart.
What is Transposition of the Great Arteries?
This is a form of cyanotic congenital heart disease. This is where the pulmonary trunk and aorta in the heart swap positions.
What is the acute and definitive management of Transposition of the Great Arteries?
(*MLA question)
Management:
1st line- E2 prostoglandin to keep the ductus arteriosus open and maintain blood supply
Definitive Mangement:
Arterial Switch Operation- Aorta and pulmonary trunk are switched to correct their positions
What is the definitive management for Transposition of the Great Vessels?
Definitive Mangement:
Arterial Switch Operation- Aorta and pulmonary trunk are switched to correct their positions
Ejection systolic at the left sternal edge is most associated with?
(*common MLA)
Atrial septal defect (ASD)
(a CLOSEST to E- need to know)
What is a Tet Spell?
b) What congenital cardiac condition is it associated with?
c) what are the causes
Tet spells are intermittent cyanotic episodes caused by a temporary worsening of the right-to-left shunt.
causes- distress, squatting or physical exertion due to extra CO2 retention
Management:
What is the management of Tet Spells?
b) these are associate with Tetralogy of fallot exacerbations due to excess VO2 retention during exercise or distress
Oxygen
IV morphine (decreases respiratory drive and pulmonary vascular resistance)
IV fluids (increases circulating volume)
IV beta blockers (e.g., propranolol)
Phenylephrine infusion (increases systemic vascular resistance)
high flow O2 makes no difference in what congenital heart condition
transposition of great arteries-pulmonary arteries and aorta switched so circuit is fucked
What main feature in tetralogy of fallot controls the extent of cyanosis
pulmonary stenosis
