paeds cardio Flashcards
how does pda murmur sound?
continuous murmur loudest over left clavicle
pulm stenosis murmur?
systolic murmur
ASD murmur?
ASDs have a fixed split S2 sound`
VSD murmur?
pansystolic murmur
does a benign ejection systolic murmur vary with posture?
yes
how does tetralogy of fallot murmur sound?
ejection systolic murmur at left sternal edge
What are acyanotic conditions?
- ventricular septal defect
- atrial septal defects
- pda
- coarctation of aorta
- aortic valve stenosis
what are cyanotic conditions?
- tetralogy of fallot
- transposition of great arteries
- tricuspid atresia
what type of shunt causes breathlessness?
Left to right shunt
VSD
PDA
ASD
what are the left to right shunts?
VSD
ASD
PDA
what type of shunt causes cyanosis?
Right to Left shunt
ToF
transposition of great arteries
list some cyanotic heart shunts?
ToF
transposition of great arteries
what does the PDA join?
joins pulmonary artery to aorta. hence breathlessness
what is the most common congenital heart defect?
VSD
what are the signs of VSD?
tachycardia tachypnoea Failure to thrive heart failure pansystolic murmur (lower left sternal edge)
how is VSD managed?
if small, will close spontaneously
if large, surgery and diuretics
what are the signs of ASD?
none tachypnoea failure to thrive wheeze ejection systolic murmur (upper left sternal edge)
how is ASD managed?
if large, surgical
when does pda usually close?
1 week in term infant
what are symptoms of pda?
tachypnoea
failure to thrive
continuous machine like murmur (below L clavicle)
bounding pulse
how is pda treated?
NSAIDs (ibuprofen or indomethacin)
surgical ligation
what are the 4 components of ToF?
- VSD
- Overriding aorta
- RVH
- Pulmonary stenosis
how does Tof present?
- severe cyanosis
- hypercyanotic spells on exercise, crying, defecating
- squatting on exercise
- ejection systolic murmur
- clubbing of fingers/toes (late)
when would you get hypercyanotic spells in tof
crying
exercise
defecation
what murmur would you hear in tof?
ejection systolic
how is tof managed?
VSD closure surgery at 6m
and relieve pulm outlet obstruction
what is transposition of great arteries?
pulmonary artery and aorta swap
what are the symptoms of transposition?
often present on day 2 of life after PDA closes with severe life-threatening cyanosis
is transposition of arteries ductal dependent?
yes!!!
how is transposition treated?
maintain PDA - prostaglandin infusions
surgical - atrial septostomy and correction
what type of heart block does congenital SLE cause?
complete heart block
what does first degree heart block look like?
PR interval >0.2s
what does second degree mobitz I heart block look like?
progressive prolongation of PR until a dropped beat
what does second degree mobitz II heart block look like?
PR interval constant, but P often not followed by QRS
what does complete (3rd) heart block look like?
no association between P and QRS
what does LBBB look like?
william
W in V1, M in V6
what does RBBB look like?
marrow
M in V1, W in V6
what condition causes supraventricular tachy?
wolff-parkinson white
what does SVT look like on ecg?
narrow QRS. very tachy
what is asscociated with wolff-parkinson white?
ebstein’s anomaly due to lithium in preg
