Pediatric Cardiology Flashcards
What are 3 of the most common congenital heart defects ?
Ventricular septal defect (VSD).
Patent ductus arteriosus (PDA)
Atrial Septal Defect (ASD)
What congenital heart defects are common in trisomy 21 ?
AVSD (Atrio-ventricular septo defect)
ASD
VSD
What cardiac abnormality is common in turner syndrome ?
Co-arctation of the aorta
What is the common cardiac abnormality found in Noonan’s syndrome ?
Pulmonary stenosis
What is the common cardiac abnormality found in William’s syndrome ?
Supravalvular aortic stenosis
What is the characterization of murmurs ?
Timing i the cycle (Systole, Diastole or continuous).
Duration (Early, mid or late)
Pitch/Quality
What are some common features of a pediatric murmur ?
Systolic murmur
Vibratory/Musical
Localized
Varied with position, resp and exercise
What is another name for Still’s Murmur ?
LV outflow murmur
What are the clinical features of Still’s Murmur?
Age 2-7
Soft, systolic vibratory murmur.
Apex, left sternal border.
Increases in supine position and with exercise.
What are the clinical features of pulmonary outflow murmurs ?
Age 8-10
Soft systolic
Upper left sternal border, well localised.
Increase in supine position with exercise.
Often in children with narrow chest.
What are the clinical features of carotid/brachiocephal IC Arterial Bruits ?
Age 2-10 years
Supraclavicular, radiates to the neck.
Increases with exercise, decreases on turning their head of extending the neck.
What are the clinical signs of venous hum ?
Age 3-8 years.
Continuous murmur.
Supraclavicular.
Only in upright position, disappears on lying down or when turning head.
What are the 3 main types of ventricular septal defects ?
Subaortic
Perimembranous
Muscular
What is the clinical presentation of ventricular septal defects ?
Small VSD - Early systolic murmur
Large VSD - Diastolic rumble due to relative mitral stenosis.
What are the symptoms of pulmonary stenosis ?
Asymptomatic in mild stenosis.
In moderate and severe extertional dyspnoea and fatigue.
Ejection systolic murmur upper left sternal border with radiation to back.
What are the symptoms of aortic stenosis ?
Asymptomatic unless severe, then reduced exercise tolerance and exertional chest pain and syncope.
Ejection systolic murmur upper right sternal border with radiation into carotids.
What changes occur in the fetal circulation at birth ?
Pulmonary Vascular Resistance Falls Pulmonary Blood Flow Rises Systemic Vascular Resistance is increased Ductus Arteriosus Closes Foramen Ovale Closes Ductus Venosus Closes
What group is PDA common in and how is it treated ?
Pre-term infants.
Fluid restriction/diuretics and prostaglandin inhibitors.
Ligation.
In term babies there is a good chance of spontaneous closure.
How do you manage coarctation of the aorta ?
Re-open DA with prostaglandin E1 or E2
Resection with end-to-end anastamosis.
Subclavian patch repair.
Balloon Aortoplasty.
What is Teratology of Fallot ?
A combination of 4 defects including VSD, pulmonary valve stenosis, misplaced aorta and right ventricular hypertrophy.
