pediatric cardio Flashcards
3 things age-dependant problem based approach is on
- cyanosis
- hearth failure
- arrythm/syncope/chest pain
things to ask on Hx
- failure to thrive
- chest infecitons
- dev. delays
- joint pain/rashes/sore throat
- Sx of heart failure
- chest pain/syncope
3 important maternal Qs to ask
- maternal infections
- myocardidits
- rubella - maternal meds
- illnesses
4 things to look for on inspection
- appearance
- dysmorphism
- cyanosis
- resp. distress
5 things on auscultation
- location and streght of murmur
- systolic/diastolic
- brachial/femoral discrepancy
- widely split heart sounds
- clicks mid systole - mitral valve prolapse
2 things to palpate for
- feel pulses to help determine perfusion
2. palpate heart for murmur or heart strain
why are L sided issues not apparent right away
babies dependent on the R side for first few days
what cause cyanosis
- not anemia
- de-satuated Hb (50g/L)
4 possible causes of cyanosis
- cardiac
- abnormal mixing of blood - pulm.
- poor oxygneation
- VQ mismatch - persistent pulm. HT
- CNS depression
** DDx for cyanotic heart disease (7)
5 Ts
- Transposition of great arts.
- Teratlogy of fallot
- tricuspid atresia
- truncus arteriosus
- total anomalous peulm venous drainage
- Pulm atresia
- Ebstein abnormality
2 CXR clues
- pulm blood flow
2. heart size
what are most heart murmurs
innocent
features of innocent murmurs
- vibratory
- muscial
- harmonic
- systolic
- ejection
- gr 1-2
features of patho murmurs
- harsh
- non-musical
- systolic and diastilic
- ejection/pnasystolic/ cont.
- over gr2
what is still’s murmur
- innocent
- flow of blood into LV sets into vibration the chordae
- 2/6 with medium pitch
what is venous hum
- innocent
- flow of blood from the head and neck into thorax
2 add. feature of innocent murmur
- accentuated in high output states
2. children well otherwise
2 tachy’s and megaly’s of heart failure
tach 1. tachycardia 2. tachypnea meh 1. cardiomegaly 2. hepatomegaly
5 signs of infant HF
- tachy
- failure to thrive
- hepatomegaly
- cardiomegaly
- gallop rhythm
5 sings of older child HF
- tachy
- SOB, cough, fatigue
- bibasilar rales, hepatomegaly, cardiomegaly
- gallop rhyth
- high JVP, edema
2 DDx for heart failure
- low O2 content
2. high output circ. state
4 general Tx of HF
- cause
- dietary
- digoxin,diuretics
- vasopressors
what are palpitations in children
- present as extra beats, chest hurts, feel weird
- red flags - syncope, chest pain, fam Hx, Hx of sudden death
- tachy, irreg rhythm
most common arrythmias in children
- tachy most common - SVT through WPW
- vent may be associted with sudden death
best thing for chest pain
ECG
