Paeds cardio Flashcards
What are the 3 fetal shunts?
- Ductus venosus
- Ductus arteriosus
- Foramen ovale
What are 3 differentials of a pan-systolic murmur?
- MR
- TR
- VSD
What are 2 differentials of a ejection-systolic murmur?
- AS
- PS
What is a key feature of an ASD murmur?
Fixed split second heart sound
What is the murmur in patent ductus arteriosus?
Continuous crescendo-decrescendo machinery murmur
Give 4 causes of cyanotic heart disease
- VSD
- ASD
- PDA
- Transposition of the great arteries
What shunt do you get in cyanotic heart disease?
Right to left shunt
What is the Ix for PDA? What does it show?
Echocardiogram. Size and characteristics of left to right shunt
What is eisenmenger syndrome?
When pulmonary pressure rises above systemic pressure causing left-to-right shunts to reverse and become right-to-left shunts
What is the management of small ASD?
Watch and wait
What is the management of a large ASD?
Transvenous catheter closure/open heart surgery
When are septal defects typically detected?
Antenatal scans/newborn baby check
What is the management of VSD?
Same as ASD
What are patients with VSD at increased risk of?
Infective endocarditis
What 3 underlying conditions can result in Eisenmenger syndrome?
- ASD
- VSD
- PDA
What is the definitive treatment of Eisenmenger syndrome?
Heart-lung transplant
What is the management of coarctation of the aorta in neonates where there is risk of heart failure?
Prostaglandin E to maintain the ductus arteriosus while waiting for surgery
What are the 4 pathologies in Tetralogy of Fallot?
- VSD
- Overriding aorta
- Pulmonary valve stenosis
- RV hypertrophy
What infection is a risk factor for Tetralogy of Fallot?
Rubella
What would a CXR show in Tetralogy of Fallot?
Boot shaped heart due to right ventricular thickening
Tet spells:
1. What are they?
2. What causes them?
3. When do they happen?
4. Symptoms?
5. Immediate response?
- Intermittent periods where a right-to-left shunt temporarily worsens
- Increased pulmonary vascular resistance or decreased systemic resistance
- During/following exertion
- SOB, cyanosis
- Child may squat/bring legs to chest to increase systemic resistance
What is the initial and definitive management of Tetralogy of Fallot?
- Prostaglandin infusion to maintain ductus arteriosus
- Total surgical repair by open heart surgery
What age is coarctation of the aorta surgically repaired?
2-4 years
What circumstance can babies with transposition of the great arteries present after a few weeks?
If have VSD/PDA so are able to partially compensate.
What is the murmur in VSD?
Pansystolic murmur heard loudest at the lower left sternal boarder
What is the murmur in TOF?
Harsh ejection systolic murmur head loudest over the upper-left sternal edge
What is the murmur in coarctation of the aorta?
Murmur head on the back between the scapula
What is the murmur in ASD?
Ejection systolic murmur heard loudest at the upper left sternal boarder
