Peds Cardio X3 Flashcards
Cardiac disease in infants SX
FTT
Tachypnea with feeding/activity
Cadiac disease in older children sx
palpitations, chest pain
dizzines/syncope
exercise intolerance,
unexplained hypertension
what will hepatomegaly and Ascities indiicate
R sided heart failure
Clubbing of fingers/toes associated with?
appears after age 1
with cyanotic congenital heart disease
Echocardiogram
Gold standard
Ultrasound of the heart
1. Transthorasic echo (more common)
2. Transesophageal echo
EKG
evaluates electrical activity and cardiac postition
-evolves with age
CXR
exaluates
- position of heart/size/shape
- position of abdominal viscera
- pulmonary vasculature
Cardiac Catherization
fluroscopy when a wire is threaded up to the heart
- radioopaque dye injecednto evaluate anatomy
- samples and measure pressure
Innocent Murmurs characteristics
- no FH
- -<= 2grade 2
- short systolic duration
- minimal radiation
- soft intensity
- musical or vibratory quality
- normal pulse
- normal pulse ox,CXR, EKG
Still murmur
-most common innocent murmur
musical/vibratory
-short high pitched
- loudest supine, dimishes/disappears with inspiration or sitting
Pulmonary flow murmur
most common in older children and alsults >3
- sof SEM
- louder supine
venoud hum
2 and up continuous musical hum -hear at R/L USB *louder in diastole** -disappears with turning head or placing shild in supine
Acyanotic congenital heart disease
Vesntral septal defect
atrial septal defect
patent ductus arteriosis
coartication of aorta
Cyanotic conegital heart disease
- tetrlogy of Fallot
- transposition of the great arteries
- tricuspid ateriosus
- total anomalous pulmonry venoud return
-hypoplastic left heart syndrome
when should the ductus arteriosus close?
14 days
Vesntricular septal defect (VSD)
- most common congenital heart defet
- associated trisomy 21 and tetralogy of fallot
VSD presentation
Small VSD may be aymptomatic
Larger: FTT, poor growth, dyspnea, frequent respiratory infections
PE: tachycardia, tachypnea, hepatomegaly
**blowing harsh holosystolic murmur LLSB
VSD dx
Echo: locates
EKG: LVH
CXR: cardiomegaly, increased pulmonary vascular markings
VSD Managment
wait and see> esp with asymptomatic
Med: tx CHF (diuretic Ace inhibitor
Surgical: septal occlusion via caterization
* prefereec surgical closure via median sternotomy
Atrial Septal defect ASD classifies
Ostium secundum (most common)> oftenisolated Ostium primum> often associaye with other anomolies
ASD presentation
CHF, recurrent resp infections FTT
-fixed widely split s2 at pulmonary area
@ULSB
-surgical patch if larger than 6mm
Eisenmenger syndrome
if you have a PDA for a log time and the shunt can reverse at high pulomary pressures casuing cyanosis
Tx of PDA
Monitor
Keep open : IV prostagladin E1
Close it up : IV indomethacin (prostagandin inhibit)
Surgery if nonresponders
Coarctation of the Aorta
Narrowing of the aortic arch in the proximaldecending aorta near takeoff of the left subclavian artery