Pediatric Cardiology Flashcards
What are 3 things that close AFTER BIRTH in the newborn’s heart?
- Foramen ovale
- Ductus Arteriosus
- Ductus Venosus
What does Foramen Ovale connect and why?
Connects the right atrium to the left atrium so that blood can bypass the lungs in utero
What does the Ductus Arteriosus connect and why?
Connects the pulmonary trunk to the aorta so that blood bypasses the developing lungs in utero
Once Ductus Arteriosus closes, what does it become?
Ligamentum Arteriosum
Describe the blood flow through the Ductus Venosus?
Oxygen rich from placenta -> Umbilical vein -> ductus venosus -> inferior vena cava -> heart
Once Ductus Venosus closes, what does it become?
Ligamentum Venosum
When does foramen ovale, ductus arteriosus and ductus venosus close?
After birth
What is the purpose of the newborn pulse oximetry screening test?
Identify babies at risk for sudden death from critical congenital heart disease
The newborn pulse oximetry screening test is NOT a diagnostic test. If the baby fails the screening, what is required?
Further hypoxemia work up
What is the purpose of the newborn pulse oximetry screening test?
Identify babies at risk for sudden death from critical congenital heart disease – hypoxemia
When will a baby fail the newborn pulse oximetry screen?
- O2 sats are less than 90%
2. Right hand sat. is between 90-95% OR difference between right hand and foot is greater than 3%
When will a baby fail the newborn pulse oximetry screening test?
- O2 sats are less than 90%
2. Right hand sat. is between 90-95% OR difference between the right hand and foot is greater than 3%
If a baby fails the newborn pulse oximetry screening, when should it be repeated?
1 hour later
What are the symptoms of a newborn with significant cardiac disease?
Cyanosis, tachypnea, cough, diaphoresis, cannot finish a bottle with failure to gain weight and developmental delay
What will be seen on physical exam with a newborn that has significant cardiac disease?
Hypoxia, wheeze/crackles, murmur, abnormal pulses, edema
What are the symptoms of an adolescent with significant cardiac disease?
Syncope, easy fatigue/exercise intolerance, palpitations or chest pain, diaphoresis, asthma-like
What will be seen on physical exam of an adolescent with significant cardiac disease?
Hypoxia, wheeze/crackles, murmur, abnormal pulses, edema
A baby with tachypnea means the RR is > than?
60 breaths/minute
What can tachypnea in a newborn be a sign of?
Congenital heart disease
What are some differential diagnoses for a baby with a RR > 60?
Congenital heart disease, RDS, infection, meconium aspiration, pneumothorax
What are the 6 components of a cardiac murmur?
- Grade 1-6
- Timing
- Character
- Location
- Radiation
- Change with position of patient
What are the 6 components of a cardiac murmur?
- Grade 1-6
- Timing
- Character
- Location
- Radiation
- Change with position of patient
What are the 7 S’s of INNOCENT murmurs in children?
- Sensitive to position change
- Short duration
- Single sound
- Small and non-radiating
- Soft (grade <3)
- Sweet (not harsh)
- Systolic
What are the 7 S’s of INNOCENT murmurs in children?
- Sensitive to position change
- Shorter duration
- Single sound
- Small (non-radiating(
- Soft (grade <3)
- Sweet
- Systolic
Innocent murmurs in children often change with _____ while pathologic murmurs do NOT
Child’s position
What is an exception to a pathologic murmur that changes with a child’s position and when does it change?
Idiopathic Hypertrophic Sub-aortic Stenosis
– Gets louder from supine -> upright
What is an exception to a pathologic murmur in children that DOES change with the child’s position and when does it change?
Idiopathic Hypertrophic Sub-aortic Stenosis
– gets louder from supine -> upright
_____ murmurs need further evaluation
Diastolic
BP range varies with what 2 things?
Age and height
If the BP cuff is too small, the BP will be?
High
If the BP cuff is too big, the BP will be?
Low
BP cuff should cover ____ of the child’s arm
2/3
BP range in a child varies with?
Age and height
