Peds Cardio X3 Flashcards

1
Q

Cardiac disease in infants SX

A

FTT

Tachypnea with feeding/activity

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2
Q

Cadiac disease in older children sx

A

palpitations, chest pain
dizzines/syncope
exercise intolerance,
unexplained hypertension

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3
Q

what will hepatomegaly and Ascities indiicate

A

R sided heart failure

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4
Q

Clubbing of fingers/toes associated with?

A

appears after age 1

with cyanotic congenital heart disease

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5
Q

Echocardiogram

A

Gold standard
Ultrasound of the heart
1. Transthorasic echo (more common)
2. Transesophageal echo

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6
Q

EKG

A

evaluates electrical activity and cardiac postition

-evolves with age

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7
Q

CXR

A

exaluates

  • position of heart/size/shape
  • position of abdominal viscera
  • pulmonary vasculature
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8
Q

Cardiac Catherization

A

fluroscopy when a wire is threaded up to the heart

  • radioopaque dye injecednto evaluate anatomy
  • samples and measure pressure
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9
Q

Innocent Murmurs characteristics

A
  • no FH
  • -<= 2grade 2
  • short systolic duration
  • minimal radiation
  • soft intensity
  • musical or vibratory quality
  • normal pulse
  • normal pulse ox,CXR, EKG
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10
Q

Still murmur

A

-most common innocent murmur
musical/vibratory
-short high pitched
- loudest supine, dimishes/disappears with inspiration or sitting

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11
Q

Pulmonary flow murmur

A

most common in older children and alsults >3

  • sof SEM
  • louder supine
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12
Q

venoud hum

A
2 and up 
continuous musical hum 
-hear at R/L USB 
*louder in diastole**
-disappears with turning head or placing shild in supine
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13
Q

Acyanotic congenital heart disease

A

Vesntral septal defect
atrial septal defect
patent ductus arteriosis
coartication of aorta

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14
Q

Cyanotic conegital heart disease

A
  • tetrlogy of Fallot
  • transposition of the great arteries
  • tricuspid ateriosus
  • total anomalous pulmonry venoud return

-hypoplastic left heart syndrome

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15
Q

when should the ductus arteriosus close?

A

14 days

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16
Q

Vesntricular septal defect (VSD)

A
  • most common congenital heart defet

- associated trisomy 21 and tetralogy of fallot

17
Q

VSD presentation

A

Small VSD may be aymptomatic
Larger: FTT, poor growth, dyspnea, frequent respiratory infections
PE: tachycardia, tachypnea, hepatomegaly
**blowing harsh holosystolic murmur LLSB

18
Q

VSD dx

A

Echo: locates
EKG: LVH
CXR: cardiomegaly, increased pulmonary vascular markings

19
Q

VSD Managment

A

wait and see> esp with asymptomatic
Med: tx CHF (diuretic Ace inhibitor
Surgical: septal occlusion via caterization
* prefereec surgical closure via median sternotomy

20
Q

Atrial Septal defect ASD classifies

A
Ostium secundum (most common)> oftenisolated 
Ostium primum> often associaye with other anomolies
21
Q

ASD presentation

A

CHF, recurrent resp infections FTT
-fixed widely split s2 at pulmonary area
@ULSB
-surgical patch if larger than 6mm

22
Q

Eisenmenger syndrome

A

if you have a PDA for a log time and the shunt can reverse at high pulomary pressures casuing cyanosis

23
Q

Tx of PDA

A

Monitor
Keep open : IV prostagladin E1
Close it up : IV indomethacin (prostagandin inhibit)
Surgery if nonresponders

24
Q

Coarctation of the Aorta

A

Narrowing of the aortic arch in the proximaldecending aorta near takeoff of the left subclavian artery

25
What is female coarctation of the aorta associated with
Turner syndrome
26
Coarctation of the aorta
``` Echo CXR -figure 3 sign -inferior rib notching Tx: surgery ```
27
Teralogy of fallot
``` Righ ventricular hypertrophy ventricular septal defect overiding aorta RV outflow obstruction **most common cyanotic CHD ```
28
Tetralogy of fallot presentation
"Test spells" - begins 4-6 mo - sunden onset or worsening of cyanosis - alterations of consciousness (irratable to syncope ) - often occuring with crying or feeding or exercise - toddlers may squat to relieve dyspnea
29
tetralogy of fallot
``` Pe: harsh systolic ejection ULSB echo-DX CXR: boot shaped heart > upturned apex Tx: oxygen knees to chest surgery by age 1 ```
30
Tranpostion of the great arteries
second most common -no murmur becuase no holes in heart Presentation: profoundly cyanotic neonate " blue baby
31
What do you need to keep open in transposition of great arteries
keep ASD open or PFO!! | so you can get some mixing of blood
32
Tx: of transposition of vessels
-balloon atrial septostomy to improve intraatrial communication -prostaglandin E1 administration -keep ductus art open -Surgery 4-7 days arterial switch operation
33
Tricuspid Atresia
absence of a tricuspid valve - must occur with other defects at the sme time becuase we need to keep blood goign
34
Tricuspid atresia pres
centra cyanosis at birth, single heart sound FTT tachpnea axhaustion during feeding Tx: prostaglandin E1 to maintain PDA > surgery
35
Truncus Arteriorsis
aorta and PA fail to separate **VSD is always present Sx: poor feeding lethary respiratory distress. narrow s2 spil at LLSB
36
Total ANomalous Pulmonary venoud return
pulmonary veins drain into venoud system *need some kind of R to Left shunt for oxygenation Sx: varies depedning on location of venous connection Tx: surgery