TCVS Flashcards
______ produces symptoms of pressure on the tracheobronchial tree and pressure on
the esophagus
Vascular ring
SSx of patients with vascular ring
The first include stridor and episodes of respiratory distress with “crowing” respiration, during which the baby assumes a hyperextended position
Morphologic cardiac anomalies (congenital or acquired) are best diagnosed with an _____
echocardiogram.
________has a very minor, low-pressure, low-volume shunt. Patients typically grow into late infancy before they are recognized
An atrial septal defect
PE of ASD
A faint pulmonary flow systolic murmur
and fixed split second heart sound are characteristic
_______ low in the muscular septum produce a heart
murmur, but otherwise few symptoms. They are likely to close spontaneously within the first 2 or 3 years of life
Small, restrictive ventricular septal defects
A ventricular septal defect (VSD) in the more typical location __________
leads to trouble early on
high in the membranous septum)
__________becomes symptomatic in the first few days of life. There are bounding peripheral pulses and a continuous “machinery-like” heart murmur
Patent ductus arteriosus
In premature infants who have not gone into CHF, closure can be achieved with ______
indomethacin.
______ share the presence of a murmur, diminished vascular markings in the lung, and cyanosis
Right-to-left shunts
TOF components
Tetralogy of Fallot (VSD, pulmonary stenosis, overiridng aorta, and right ventricular
hypertrophy),
Murmur of TOF
There is a systolic ejection murmur in the left third intercostal space, a small heart
TGA
Children are kept alive early on by:
atrial septal defect, ventricular septal defect, or patent ductus (or a combination), but die very soon if not corrected
_______ produces angina, syncope, and dyspnea. There is a harsh midsystolic heart murmur best heard at the right second intercostal space and along the left sternal border.
Aortic stenosis
When to do Sx in AS
Surgical valvular replacement is indicated if there is a
gradient >50 mm Hg, or at the first indication of CHF, angina, or syncope.
Murmur of AI
new, loud diastolic murmur at the right second intercostal space
Mitral stenosis is caused by a ______
history of rheumatic fever many years before presentation.
Murmur of MS
There is a low-pitched, rumbling diastolic apical heart murmur
TX of MS
mitral valve repair becomes necessary with
a surgical commissurotomy or mitral valve replacement
______ is most commonly caused by valvular prolapse. Patients develop exertional dyspnea, orthopnea, and atrial fibrillation.
Mitral regurgitation
Mitral regurgitation murmur
There is an apical, high-pitched, holosystolic
heart murmur that radiates to the axilla and back
Indication for cardiac catheterization
Intervention is indicated if ≥1 vessels
have ≥70% stenosis and there is a good distal vessel. Preferably, the patient should still have
good ventricular function (you cannot resuscitate dead myocardium).
The general rule for coronary disease is that the simpler the problem, the more it is amenable to _____and
stent; whereas more complex situations do better with _____
angioplasty
surgery
A solitary “coin” lesion found on a chest x-ray has an _____ chance of being malignant in
people age >50, and even higher if there is a significant history of smoking
80%
Diagnosis of cancer of the lung, if not established by cytology, requires ______ or ______
bronchoscopy and biopsies (for central lesions) or percutaneous biopsy (for peripheral lesions).
_______ is treated with chemotherapy and radiation, and therefore assessment of operability and curative chances of surgery are not applicable
Small cell cancer of the lung
A minimum FEV1 of_____ is mandatory for a patient to undergo lung resection, as the worst case scenario is that a pneumonectomy will need to be performed and could potentially leave a marginal patient ventilator dependent.
800 mL
