Paeds cardio

Question 1

What are the 3 fetal shunts?

Answer 1

• Ductus venosus
• Ductus arteriosus
• Foramen ovale

Question 2

What are 3 differentials of a pan-systolic murmur?

Answer 2

• MR
• TR
• VSD

Question 3

What are 2 differentials of a ejection-systolic murmur?

Answer 3

• AS
• PS

Question 4

What is a key feature of an ASD murmur?

Answer 4

Fixed split second heart sound

Question 5

What is the murmur in patent ductus arteriosus?

Answer 5

Continuous crescendo-decrescendo machinery murmur

Question 6

Give 4 causes of cyanotic heart disease

Answer 6

1. VSD
2. ASD
3. PDA
4. Transposition of the great arteries

Question 7

What shunt do you get in cyanotic heart disease?

Answer 7

Right to left shunt

Question 8

What is the Ix for PDA? What does it show?

Answer 8

Echocardiogram. Size and characteristics of left to right shunt

Question 9

What is eisenmenger syndrome?

Answer 9

When pulmonary pressure rises above systemic pressure causing left-to-right shunts to reverse and become right-to-left shunts

Question 10

What is the management of small ASD?

Answer 10

Watch and wait

Question 11

What is the management of a large ASD?

Answer 11

Transvenous catheter closure/open heart surgery

Question 12

When are septal defects typically detected?

Answer 12

Antenatal scans/newborn baby check

Question 13

What is the management of VSD?

Answer 13

Same as ASD

Question 14

What are patients with VSD at increased risk of?

Answer 14

Infective endocarditis

Question 15

What 3 underlying conditions can result in Eisenmenger syndrome?

Answer 15

• ASD
• VSD
• PDA

Question 16

What is the definitive treatment of Eisenmenger syndrome?

Answer 16

Heart-lung transplant

Question 17

What is the management of coarctation of the aorta in neonates where there is risk of heart failure?

Answer 17

Prostaglandin E to maintain the ductus arteriosus while waiting for surgery

Question 18

What are the 4 pathologies in Tetralogy of Fallot?

Answer 18

• VSD
• Overriding aorta
• Pulmonary valve stenosis
• RV hypertrophy

Question 19

What infection is a risk factor for Tetralogy of Fallot?

Answer 19

Rubella

Question 20

What would a CXR show in Tetralogy of Fallot?

Answer 20

Boot shaped heart due to right ventricular thickening

Question 21

Tet spells:
1. What are they?
2. What causes them?
3. When do they happen?
4. Symptoms?
5. Immediate response?

Answer 21

1. Intermittent periods where a right-to-left shunt temporarily worsens
2. Increased pulmonary vascular resistance or decreased systemic resistance
3. During/following exertion
4. SOB, cyanosis
5. Child may squat/bring legs to chest to increase systemic resistance

Question 22

What is the initial and definitive management of Tetralogy of Fallot?

Answer 22

• Prostaglandin infusion to maintain ductus arteriosus
• Total surgical repair by open heart surgery

Question 23

What age is coarctation of the aorta surgically repaired?

Answer 23

2-4 years

Question 24

What circumstance can babies with transposition of the great arteries present after a few weeks?

Answer 24

If have VSD/PDA so are able to partially compensate.

Question 25

What is the murmur in VSD?

Answer 25

Pansystolic murmur heard loudest at the lower left sternal boarder

Question 26

What is the murmur in TOF?

Answer 26

Harsh ejection systolic murmur head loudest over the upper-left sternal edge

Question 27

What is the murmur in coarctation of the aorta?

Answer 27

Murmur head on the back between the scapula

Question 28

What is the murmur in ASD?

Answer 28

Ejection systolic murmur heard loudest at the upper left sternal boarder