PEDS cardio Flashcards
VSD
ASD
PDA
Coarctation of aorta
examples of…
acyanotic congenital heart disease
tetralogy of fallot
transposition of great arteries
tricuspid atresia
truncus arteriosus
total anomalous pulmonary venous return
hypoplastic left vent
examples of…
cyanotic congenital heart disease
acute rheumatic fever
kawasaki
hypertrophic cardiomyopathy
acquired heart disease
poor weight gain, FTT
tachypnea w/ feeding or activity
concerning for…
cardiac disease in infants
in older children…
palpitations/CP
syncope
dyspnea on exertion
unexplained HTN
Concerning for…
cardiac disease
What grade of murmur comes with a palpable thrill?
grade 4
what heart murmur grade is associated with murmur audible with light placement of stethoscope?
grade 5
murmur that is heart with stethoscope off chest
grade 6
murmur that can often be heard only by cardiologists
grade 1
hepatomegaly/ascites indicates what
right heart failure
what type of echocardiogram is most commonly used/gold standard?
transthoracic echo
no fhx
short systolic murmur
soft, grade 2 or less
normal physical
What type of murmur is this?
innocent
fhx of heart disease
holosystolic/diastolic murmur
grade 3-6 murmur
blowing/harsh quality
abnormal pulse, vitals, hepatomegaly, MSK abnormalities
pathologic
this murmur is…
age 2-7
musical/vibratory
heard at LLSB
Loudest supine, diminishes with inspiration or sitting
still murmur (innocent)
“From 2-7 I can STILL be MUSICAL if I LAY on my LEFT and BREATH DEEP”
this murmur is…
age 3 or older
the most common innocent murmur
soft
upper left sternal border
louder supine
pulmonary flow murmur
this murmur…
age 2 or older
musical hum
grade 1-3
heard at R/LUSB
louder in diastole and in sitting position
disappears with head turning or supine
venous hum
Most common congenital heart defect
associated with trisomy 21, tetralogy of fallot
VSD
presents with…
FTT, poor growth, dyspnea
hepatomegaly
harsh, holosystolic murmur at LLSB
VSD
what can you see on EKG for VSD?
LVH
VSD tx options
wait and see if asymptomatic
Medical diuretic, ace inhibitor, digoxin
surgical: if failing medical, cardiac cath, closure via median sternotomy
defect in closure of foramen ovale ostium secundum
ASD
most common right to left shunt
ASD
Wide S2 split
midsystolic pulmonary flow ejection murmur at ULSB
ASD
tx for ASD
spontaneous closure
surgical patch if over 6mm
continuous machinery murmur
wide pulse pressure
bounding pulses
PDA
Tx for PDA
open: IV prostaglandin E1
close: IV indomethacin
common w/ turner syndrome
unexplained UE hypertension
coarctation of aorta
absent or decreased femoral pulses
UE SBP > 20mmhg than LE SBP
blowing systolic murmur in back or left axilla
coarctation of aorta
Dx of coarctation of aorta
figure 3 sign or inferior rib notching on CXR
Tx for coarctation of the aorta
surgery
5 Ts are…
tetralogy of fallot transposition of great arteries tricuspid atresia truncus arteriosus TAPVR
RVH
VSD
Overriding aorta
RV outflow stenosis
This is…
tetralogy of fallot
What is the most common cyanotic CHD?
tetralogy of fallot
squatting to relieve dyspnea
harsh systolic ejection murmur
“Tet spells”
ToF
how do you dx ToF?
echo
“boot shaped” heart on CXR
Tx for ToF
tet spells: O2, knee to chest
surgical repair by age 1
profoundly cyonotic neonate
no respiratory distress or murmur
transposition of great arteries
Dx for transposition of great arteries
echo
CXR showing “egg on a string”
Tx for transposition of great arteries
Prostaglandin E1 to keep PDA
cardiac cath
surgery at age 4-7 days
central cyanosis at birth
S2 only heart sound
FTT
tachypnea
exhaustion during feeding
tricuspid atresia
tx for tricuspid atresia
initial: PGE1 to maintain PDA
definitive: surgery
VSD
poor feeding, lethargy
loud, narrow S2 split
ejection click
systolic ejection murmur at LLSB
truncus arteriosus
hypoplasia of LV
mild cyanosis while PDA
rapid shock when ductus arteriosus closes
hypoplastic left heart syndrome
Tx for hypoplastic left heart syndrome
PGE1 to maintain PDA
staged surgeries
commonly causes at ASD/VSD, ToF, PDA
trisomy 21
commonly causes bicuspid aortic valve, VSD, ASD, CoA, dialated aortic root, HTN
Turner Syndrome
common cause of VSD/ASD
fetal alcohol syndrome
common cause of PDA, pulmonary stenosis
maternal rubella
pancarditis
appears after GAS infx
acute rheumatic fever
tx of acute rheumatic fever
CS or aspirin
abx
HF mgmt
Fever greater than 5 days
Conjunctivitis Rash erythema palms/soles Adenopathy Mucous membrane (strawberry tongue)
Kawasaki
complications of kawasaki
coronary artery aneurysm
leading cause of sudden cardiac death in young people
familial autosomal dominant inheritance
hypertrophic cardiomyopathy
dx of hypertrophic cardiomyopathy
echo, ekg, audible S4
severe cyanosis
respiratory distress
CHF
pulmonary veins draining in the venous system
total anomalous pulmonary venous return
Tx with surgery
