Pediatric Cardiology

Question 1

What are 3 of the most common congenital heart defects ?

Answer 1

Ventricular septal defect (VSD).
Patent ductus arteriosus (PDA)
Atrial Septal Defect (ASD)

Question 2

What congenital heart defects are common in trisomy 21 ?

Answer 2

AVSD (Atrio-ventricular septo defect)
ASD
VSD

Question 3

What cardiac abnormality is common in turner syndrome ?

Answer 3

Co-arctation of the aorta

Question 4

What is the common cardiac abnormality found in Noonan’s syndrome ?

Answer 4

Pulmonary stenosis

Question 5

What is the common cardiac abnormality found in William’s syndrome ?

Answer 5

Supravalvular aortic stenosis

Question 6

What is the characterization of murmurs ?

Answer 6

Timing i the cycle (Systole, Diastole or continuous).

Duration (Early, mid or late)

Pitch/Quality

Question 7

What are some common features of a pediatric murmur ?

Answer 7

Systolic murmur
Vibratory/Musical
Localized
Varied with position, resp and exercise

Question 8

What is another name for Still’s Murmur ?

Answer 8

LV outflow murmur

Question 9

What are the clinical features of Still’s Murmur?

Answer 9

Age 2-7
Soft, systolic vibratory murmur.
Apex, left sternal border.
Increases in supine position and with exercise.

Question 10

What are the clinical features of pulmonary outflow murmurs ?

Answer 10

Age 8-10
Soft systolic
Upper left sternal border, well localised.
Increase in supine position with exercise.
Often in children with narrow chest.

Question 11

What are the clinical features of carotid/brachiocephal IC Arterial Bruits ?

Answer 11

Age 2-10 years
Supraclavicular, radiates to the neck.
Increases with exercise, decreases on turning their head of extending the neck.

Question 12

What are the clinical signs of venous hum ?

Answer 12

Age 3-8 years.

Continuous murmur.

Supraclavicular.

Only in upright position, disappears on lying down or when turning head.

Question 13

What are the 3 main types of ventricular septal defects ?

Answer 13

Subaortic
Perimembranous
Muscular

Question 14

What is the clinical presentation of ventricular septal defects ?

Answer 14

Small VSD - Early systolic murmur

Large VSD - Diastolic rumble due to relative mitral stenosis.

Question 15

What are the symptoms of pulmonary stenosis ?

Answer 15

Asymptomatic in mild stenosis.

In moderate and severe extertional dyspnoea and fatigue.

Ejection systolic murmur upper left sternal border with radiation to back.

Question 16

What are the symptoms of aortic stenosis ?

Answer 16

Asymptomatic unless severe, then reduced exercise tolerance and exertional chest pain and syncope.

Ejection systolic murmur upper right sternal border with radiation into carotids.

Question 17

What changes occur in the fetal circulation at birth ?

Answer 17

Pulmonary Vascular Resistance Falls
Pulmonary Blood Flow Rises
Systemic Vascular Resistance is increased
Ductus Arteriosus Closes
Foramen Ovale Closes
Ductus Venosus Closes

Question 18

What group is PDA common in and how is it treated ?

Answer 18

Pre-term infants.

Fluid restriction/diuretics and prostaglandin inhibitors.

Ligation.

In term babies there is a good chance of spontaneous closure.

Question 19

How do you manage coarctation of the aorta ?

Answer 19

Re-open DA with prostaglandin E1 or E2

Resection with end-to-end anastamosis.

Subclavian patch repair.

Balloon Aortoplasty.

Question 20

What is Teratology of Fallot ?

Answer 20

A combination of 4 defects including VSD, pulmonary valve stenosis, misplaced aorta and right ventricular hypertrophy.