Paeds Cardio Flashcards
Outline foetal circulation
Placenta –> Umbilical Vein –> IVC –>RV–>FO–>LA–>Aorta–>Umbilical arteries–>Placenta
(OR RV>PA>DA>Aorta>UA>Placenta)
What is the purpose of the foramen ovale and ductus arteriosus in foetal circulation?
Used to bypass non-functioning lungs
What 4 CHD can cause a L–>R shunt?
1) VSD
2) ASD
3) AVSD
4) PDA
What are the main signs of a VSD?
1) Poor feeding and FTT
2) Tachypnoea
3) Thrill
4) Hepatomegaly
5) Pan-systolic murmur
What would you see on a CXR for VSD?
1) Cardiomegaly
2) Pulmonary oedema
3) Enlarged pulmonary arteries
Why are ASD’s often asymptomatic?
ASD’s are often asymptomatic because the blood flow in the atria is low pressure and so breathlessness etc is uncommon.
What are the main signs of ASD?
1) Palpitations
2) Ejection-systolic murmur in pulmonary arteries
3) S2 sound
Which chromosomal abnormality is AVSD usually found in?
Trisomy 21 (Down’s)
What are the main S/S of PDA?
Poor feeding, FTT.
Tachypnoea.
Active precordium.
Thrill.
Continuous machinery murmur.
What is the overall management for CHD for people with R>L shunts?
Stabilise the patient.
Increase calorie intake.
NG tube.
Diuretics and ACEi to prevent HF symptoms.
Surgical repair
Which shunt would cause a patient to appear cyanotic?
R–>L shunt
Name 2 congenital heart problems that can cause a R -> L shunt.
1) Tetralogy of Fallot
2) Transposition of the Great Arteries
What 4 components make up Tetralogy of fallot?
1) Pulmonary Stenosis
2) RVH
3) Overriding aorta
4) VSD
What are the main S/S of TOF?
1) Cyanosis
2) Collapse
3) Acidosis
Define coarctation of the aorta
Arterial duct tissue encircles the aorta at the point of insertion of the duct. When the duct closes, the aorta constricts, this causes severe obstruction to LV outflow.
What are the main S/S of Coarc of Aorta?
Radio-femoral delay.
Weak femoral pulses.
Difference in pre and post-ductal saturations.
What are the main S/S of aortic stenosis?
1) Palpable thrill
2) Ejection systolic murmur
3) LVH
Name 3 congenital heart problems that are often associated with Down’s syndrome.
1) AVSD
2) VSD
3) TOF
What are the main signs of pulmonary stenosis?
1) Ejection systolic murmur (Radiates to the back)
2) RV heave if severe
What is a possible consequence of persistent pulmonary hypertension?
Eisenmenger syndrome: ^ Pa, Pul BF damages pul. vasc. -> ^ Resistance (PHT)->RV pressure increase –> Shunt reverses and mixes
What is the PP behind Eisenmenger syndrome?
Persistent pulmonary hypertension -> high pressure pulm. blood flow damages pulmonary vasculature -> increased resistance (pulm. hypertension) -> RV pressure increase -> shunt direction reverses -> CYANOSIS!
