Peds CV disorders Flashcards
Atrial septal defect- Eti
- Shunting of blood between atrium
- Ostium secundum most common
- F>M
- Sporadic defect
- Low pressure- Left to right shunt
Atrial septal defect- Sx
- Fixed, split S2
- RV heave
- Exercise intolerance, fatigueablilty, heart failure
- Diastolic murmur
Atrial septal defect- Dx
- Echo with doppler
- ECG- left axis deviation
- Xray- cardiomegaly
Atrial septal defect- Tx
- Transcatheter closure
Ventricular septal defect- Eti
- Most common congenital heart malformation (30%)
- 85% are small, hemodynamically insignificant
- 50% close by 2 yo
Ventricular septal defect- Sx
- Large L>R shunt = dyspena, diaphoresis & fatigue
- Exercise intolerance
- Increased pulm/ vast resistance
- Cyanosis
Ventricular septal defect- Dx
- Echo- estimation of pressure difference
Ventricular septal defect- Tx
- Diuretics
- Surgery
AV septal defect- Eti
- Fusion of embryonic endocardial cushions
- Down syndrome
AV septal defect- Sx
- Often asymptomatic Failure to thrive - Tachypnea, diaphoresis with feeding - Pulm HTN - Recurrent pneumonia - Systolic murmur- soft, sound benign - Pulm component of S2
AV septal defect- Dx
- Echo- Rt sided volume overload
AV septal defect- Tx
Surgery- within first month of life
Patent ductus arteriosus- Eto
- Higher in altitudes > 10,000 ft
- F>M
- Persistence of normal fetal vessel joining pulm artery & aorta
Patent ductus arteriosus- Sx
- Bounding pulses with widened pulse pressure
- Rough machinery murmur at 2nd ICS, radiates into anterior lung fields
- Commonly asymptomatic
Patent ductus arteriosus- Dx
Echo
Patent ductus arteriosus- Tx
Surgical closure
Correction of aorta- Eti
- Narrowing of aortic arch in proximal descending aorta
- F>M
- Turner syndrome
- Bicuspid aortic valve
Correction of aorta- Sx
- Absent femoral pulses
- BP > 15 mmHg between arms & legs
- Systolic murmur
Correction of aorta- Dx
Echo with doppler
Correction of aorta- Tx
- Balloon angioplasty
Tetralogy of Fallot- Eti
- Anterior deviation of infundibular septum
-
Tetralogy of Fallot- Eti
- Anterior deviation of infundibular septum
- Chromosome deletion
- Ventricular septal defect with RV hypertrophy
Tetralogy of Fallot- Sx
- Hypoxemic spells, cyanosis
- Rt sided aortic arch
- Systolic ejection murmur
- Tet spells: sudden cyanosis, dyspnea, altered consciousness, decreased murmur
Tetralogy of Fallot- Dx
Echo- thick RV wall, overriding aorta
Tetralogy of Fallot- Tx
Open heart surgery
Transposition of great arteries- Eti
- Cyanotic congenital heart disease
- M>F
Transposition of great arteries- Sx
- Large neonate
- Profoundly cyanotic w/o resp distress
Transposition of great arteries- Dx
Echo
Transposition of great arteries- Tx
- Arterial switch operation
Transposition of great arteries- Tx
- Arterial switch operation
Rheumatic fever- Eti
- 1:100,000
- Group A beta hemolytic strept
- Immune response to streptococcal antigens
- 5-15 yrs
Rheumatic fever- Eti
- 1:100,000
- Group A beta hemolytic strept
- Immune response to streptococcal antigens
- 5-15 yrs
- Girls
- African american
Rheumatic fever- Sx
- Clear evidence of preceding strept infection
- Jones criteria- two major or 1 maj, 1 min:
- Maj: carditis, polyarthritis, sydenham chorea, erythema marginatum, nodules
- Minor: Prev hx, polyarthralgia, fever, Elevated ESR, CRP
Rheumatic fever- Sx/Dx
- Clear evidence of preceding strept infection
- Jones criteria-
Jones criteria:
Two major or 1 maj, 1 min:
- Maj: carditis, polyarthritis, sydenham chorea, erythema marginatum, nodules
- Minor: Prev hx, polyarthralgia, fever, Elevated ESR, CRP
Rheumatic fever- Tx
Penicillin
- Sulfadiazine if allergic
