Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Family Med EOR > Structural Cardiac Disorders and CM > Flashcards

Structural Cardiac Disorders and CM Flashcards

1
Q

What is the MC type of congenital heart disease?

A

VSD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the 4 types of VSD? Which is MC?

A
  1. Perimembranous (MC): hole in LV outflow near tricuspid valve
  2. Muscular: multiple holes in “swiss cheese” pattern
  3. Inlet: posterior to tricuspid valve
  4. Supracristal: Beneath pulmonic valve
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the s/s of small (restrictive) VSD?

A

Asx or mild
Found incidentally due to murmur
Restrictive = normal pressure btwn ventricles maintained

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are s/s of moderate VSD?

A

Excessive sweating or fatigue, esp. during feeds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are s/s of Eisenmenger’s syndrome?

A

Right to left shunt

Asx at rest, but +/- cyanosis*, dyspnea, CP, & syncope

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What does VSD look like on PE?

A

Loud high-pitched holosystolic murmur at lower left sternal border

Mod VSD: +/- thrill, diastolic rumble at mitral area

Large VSD: signs of CHF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How do you dx VSD?

A 
CXR: LA enlargement, RV hypertrophy
Echo: preferred over cath
ECG: LVH/RVH 
MRI
Cath
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How do you treat VSD?

A

Most close spontaneously within 10 years

Patch closure if sx

Larger shunts are repaired by age 2 to prevent pulmonary HTN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are characteristics of coarctation of the aorta?

A

Increased LV afterload –> HTN, LVH, CHF

70% also have bicuspid aortic valve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are s/s of coarctation of the aorta?

A

Secondary HTN*

Bilateral claudication*, dyspnea, syncope

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What does coarctation of the aorta look like on PE?

A

Systolic murmur that radiates to back/scapula/chest

Increased BP upper > LE

Delayed/weak femoral pulses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How do you dx coarctation of the aorta? What is gold standard?

A

CXR: Rib notching, “3 sign”

ECG: LVH

Angiogram = GOLD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How do you treat coarctation of the aorta?

A

Surgical repair
Balloon angioplasty +/- stent
PGE1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the MC cyanotic congenital heart disease?

A

Tetralogy of fallot (right to left shunt)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are causes of tetralogy of fallot?

A
  1. RV outflow obstruction (pulmonary artery stenosis)
  2. RV hypertrophy
  3. VSD (large unrestrictive)
  4. Overriding aorta
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are s/s of tetralogy of fallot?

A

Blue baby syndrome (cyanosis)

“Tet-spells”: older children relieve spells by squatting

Eisenmenger’s syndrome (seen w/ VSD, PDA, & TOF)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What does tetralogy of fallot look like on PE?

A

Harsh holosystolic murmur @ left upper sternal border

Right ventricular heave

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How do you dx TOF? What is GOLD?

A

CXR: boot shaped heart

ECG: RVH, RAE

Echo: GOLD

19
Q

How do you treat TOF?

A

Surgical repair performed in 1st 4-12 mos of life

PGE1 infusion (prevents ductal closure)

20
Q

What is patent ductus arteriosus?

A

Communication btwn descending thoracic aorta & pulmonary artery

Left to right shunt

21
Q

What causes PDA?

A

Prematurity
Perinatal distress & hypoxia
Rubella inf in 1st trimester

Continued PGE2

22
Q

What are s/s of PDA?

A

Most asx

Poor feeding, wt loss

Eisenmenger’s syndrome: left to right shunt switches & becomes right to left shunt

23
Q

What does PDA look like on PE?

A

Continuous machinery murmur loudest @ pulmonic area

Wide pulse pressure: bounding peripheral pulses

24
Q

How do you dx PDA? What is gold standard?

A

CXR: normal or cardiomegaly
ECG: LVH, LA enlargement
Echo = GOLD

25
Q

How do you treat PDA?

A

IV indomethacin 1st line (closes PDA)

Surgical correction if indomethacin fails. Best to be performed before 1-3yo

26
Q

What are characteristics of dilated CM?

A

Systolic dysfunction –> ventricular dilation –> dilated weak heart

MC in men, 20-60yo

27
Q

What causes dilated CM?

A
  • Idiopathic MC
  • Viral myocarditis (enteroviruses MC, PB19, Chagas)
  • Toxic: Etoh, cocaine, anthracyclines (doxorubicin)
  • Pregnancy
28
Q

What are s/s of dilated CM?

A

Systolic HF sx: Both L & R sided

+ S3

Viral myocarditis: viral prodrome a few wks –> signs of HF or CP, + cardiac enzymes

29
Q

What does dilated CM look like on PE?

A

L sided HF: pulmonary congestion

R HF: peripheral edema, increased JVP, hepatic congestion

30
Q

How do you dx dilated CM?

A

Echo:

  • LV dilation: thin walls
  • Decreased EF
  • Regional or global LV hypokinesis

CXR: Cardiomegaly

31
Q

How do you treat dilated CM?

A

Standard systolic HF tx:
ACEI, diuretics, etc.

Implantable defibrillator if EF < 35%

32
Q

What are characteristics of restrictive CM?

A

Diastolic dysfunction

Ventricular rigidity impedes ventricular filling (decreased ventricular compliance)

33
Q

What causes restrictive CM?

A

Infiltrative diseases:

  • Amyloidosis MC
  • Sarcoidosis
34
Q

What are s/s of restrictive CM?

A

R sided HF MC than L sided

tachyarrhythmias

35
Q

What does restrictive CM look like on PE?

A

Kussmaul sign (increased JVP w/ inspiration)

R-sided HF: peripheral edema, increased JVP, hepatic congestion

36
Q

How do you dx restrictive CM?

A

Echo:

  • marked dilation of both atria
  • diastolic dysfunction
37
Q

How do you treat restrictive CM?

A

No specific tx

Treat underlying cause

38
Q

What are characteristics of hypertrophic CM?

A

Diastolic dysfunction (due to impaired ventricular relaxation/filling)

Subaortic outflow obstruction: hypertrophied septum + systolic anterior motion of mitral valve increased w/ increased contractility & decreased LV volume

39
Q

What causes hypertrophic CM?

A

Inherited genetic d/o of L &/or R ventricular hypertrophy

40
Q

What are s/s of hypertrophic CM?

A 
Often asx 
dyspnea 90%. MC initial complaint 
Angina, syncope
Arrhythmias 
Sudden cardiac death (esp. exertion) due to VF
41
Q

What does hypertrophic CM look like on PE?

A

Harsh systolic cres-decresc murmur @LLSB (sounds like aortic stenosis)

  • decreased murmur intensity: increased VR (squatting, supine); handgrip
  • increased murmur: decreased VR (valsalva & standing) & exertion, amyl nitrate

Usually no carotid radiation. Loud S4

42
Q

How do you dx hypertrophic CM?

A

Echo: asymmetric wall thickness (esp. septal)

ECG: LVH

43
Q

How do you treat hypertrophic CM?

A

BBs, verapamil, ICD placement

Cautious use of digoxin, nitrates & diuretics

Septal myomectomy, Etoh ablation

Avoid dehydration & extreme exertion/exercise

Family Med EOR (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions