UW Peds Cards Flashcards
EKG showing left-axis deviation; tall, peaked P waves (d/t RAH) from ASD; small or absent R waves in precordial leads; plus CXR showing normal-sized heart
Tricuspid atresia
CXR of tricuspid atresia
decreased pulmonary vascular markings and a normal sized heart
Murmur of tricuspid atresia
Holosystolic murmur loudest at LLSB (VSD)
increased pulmonary markings and cardiomegaly from excessive pulmonary blood flow and biventricular volume overload
CXR of CAVCD
displacement of a malformed tricuspid valve into the RV –> severe TR and RAH
Ebstein’s anomaly
Tall P waves and RAD on EKG plus extreme cardiomegaly from heart failure
Ebstein’s anomaly
Increased or decreased pulmonary vascular markings on CXR with TOF?
Decreased
Defect in which all 4 pulmonary veins fail to make their normal connection to the LA, so the RA receives blood from pulmonary and systemic circumlation
TAPVR
EKG of TAPVR
RVH and RAD
CXR of truncus arteriosus
cardiomegaly and increased pulmonary vascular markings
truncus arteriosus is strongly a/w
DiGeorge
benign murmur increases or decreases with standing
Decreases
pathologic murmur increases with
standing or valsalva
Pathologic murmurs may be a/w loud, fixed split or single S2 or decreases or absent
femoral pulses
HOCM murmur increases with standing because
standing decreases venous return and preload, which increases the obstruction
3 cardiac anomalies a/w Turner
bicuspid aortic valve, coarctation, aortic root dilation (w/ inc risk of aortic dissection)
MVP is a/w
Marfan, Ehlers-Danlos, OI_
PDA is a/w
congenital rubella, Char syndrome
TOF is a/w
Down, DiGeorge
VSD is occ a/w
trisomies 13, 18, 21
carotid pulse has a dual upstroke, + strong apical impulse, + systolic ejection murmur along LSB
HOCM
Maneuvers that increase either preload or after load, such as squatting, leg raise, or sustained hand grip, increase LV cavity size in HOCM and thereby
decrease outflow obstruction –> decreased intensity of murmur
Maneuvers that decrease preload, such as Valsalva, abrupt standing, or amyl nitrate administration, decrease LV size in HOCM and thereby
increase intensity of murmur
loud S2 due to pulmonary HTN, systolic ejection murmur from increase flow across P from L to R shunt across AD, holosystolic murmur of VSD
findings on auscultation in CAVSD
pansystolic murmur that is loudest at LLSB plus diastolic rumble at apex due to increase flow across the mitral valve
VSD
stridor at age 6 mos - 6 yrs with barky cough
croup
strido most severe at age 4-8 months that worsens in supine position and improves in prone position
Laryngomalacia
stridor that presents before age 1 year, improves with neck extension, and is a/w cardiac abnormalities; does NOT improve with steroids, rac epi, or albuterol
vascular ring
w/u harsh holosystolic murmur best heard at LLSB
echo to determine location and size of VSD and r/o other defects
accentuated peripheral pulses with continuous flow murmur last LSB
PDA
mid systolic click with late systolic murmur
MVP
Syndrome a/w several cardiac abnormalities including AS, PS, or septal defects
Williams syndrome
tx PDA
indomethacin to close; prostaglandin E1 to keep open