Pediatric cardiology Flashcards
what is the etiology of rheumatic fever
Group A beta hemolytic strep (GABHS)
what is the characteristic histologic finding in the myocardium of rheumatic fever
aschoff body
what is the MC valve effected by rheumatic fever
mitral valve
what is the presentation of rheumatic fever
febrile illness 2-4 weeks following strep infection
what is the major criteria for rheumatic fever
- polyarthritis
- carditis
- subcutaneous nodules
- erythema marginatum
- chorea
what are the minor criteria for rheumatic fever
- fever
- polyarthralgia
- previous rheumatic fever/RHD
- elevated ESR/CRP
- prolonged PR interval
what is the diagnostic criteria for rheumatic fever
- 2 major criteria OR
- 1 major and 2 minor AND
- documented strep infection
- confirmation with echo
what is the treatment of rheumatic fever
- PCN
- prophylaxis for up to 10 years
what is the MC atrial septal defect
ostium secondum
what is the pathophysiology of atrial septal defects
- L to R shunt allowing oxygenated blood to pass from the LA to the RA causing the blood to mix
- eventually the R side pressure can become too much, causing it to reverse and patient becomes cyanotic
what are the s/s of ASD
- split S2 heart sound
- systolic ejection murmur radiating to the back at the LSB
- diastolic murmur at LSB
what would be seen on imaging for ASD
cardiac enlargement
what is the treatment o ASD
- small: closes on its own
- symptomatic or large: transcatheter closure
what is the pathophysiology of coarctation of the aorta
- narrowing of the aortic arch causing blockage of blood flow
- leads to LVH
Most paients with coarctation of the aorta also have (…)
turners syndrome
what are the s/s of coarctation of the aorta
- pulse discrepancy between arms and legs
- diminished femoral pulses
- blowing harsh murmur in the back or left axilla
what would you see on chest xray of coarctation of the aorta
- figure 3 sign
- rib notching
what is the treatment for coarctation of the aorta
- prostaglandins to keep PDA open
- corrective repair once stable
- balloon angioplasty
what is the pathophysiology of HCM
Thickened LV wall, particularly along the septum
what is the presentation of HCM
- CP
- syncope
- SCA
- mid-systolic harsh murmur, louder when valsalva and standing, quieter with squatting
how do you manage HCM
- avoid volume depletion
- activity restriction
- BB
- septal myectomy or alcohol septal ablation
what is the presentation of kawasaki disease
-fever more than 5 days
-lip or oral cavity changes
-bilateral conjunctivitis
-cervical lymphadenopathy
-polymorphous exanthema
-redness and swelling of hands
what are the possible complications of kawasaki disease
- myocarditis
- pericarditis
- valvular heart disease
- MI
what is the treatment of kawasaki disease
aspirin and IVIG
