2 - Paeds - CVS - Aortic Stenosis + Pulmonary Stenosis Flashcards Preview

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Flashcards in 2 - Paeds - CVS - Aortic Stenosis + Pulmonary Stenosis Deck (10)
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1
Q

AS

  • how does this happen?
  • may be ass w?
A

aortic leaflets (1-3) partly fused

possibly - mitral valve stenosis + coarctation of aorta

2
Q

AS

Sx? if severe? in neonates?

A

aSx murmur
if severe -> reduced exercise tolerance, syncope, chest pain
neonates with critical AS + duct dep systemic circulation may show severe HF > shock

3
Q

AS

physical signs?

A
small vol, slow rising pulse
carotid thrill
EjectionSM at URSternalE radiating to neck
delayed soft aortic HS2
apical ejection click
4
Q

AS

Ix

A

CXR normal or prominent left ventricle with post stenotic dilatation of ascending aorta
ECG - LVH

5
Q

AS
MGMT - how to monitor?
Why do balloon valvotomy? safest in who? end treatment?

A

regular Echos to know when to intervene
if Sx on exercise/high resting pressure gradient across AV -> balloon valvotomy
safest in older, dangerous in neonates

most needing Tx will eventually need AV replacement

6
Q

PS

how ? restricts what?

A

pulm valve leaflets partly fused

restricts bl fl exit from RV

7
Q

Ps - how diagnosed?

Sx? few have what?

A

clinical diagnosis
most aSx
few with critical PS have duct dependent pulm circulation and present with cyanosis in first few days

8
Q

PS

Physical signs?

A

ESM at ULSE, ?thrill
Ejection click at ULSE
RV heave if severe

9
Q

PS

Ix?

A
CXR normal/post stenotic dilatation
ECG RVH (upright T in V1)
10
Q

PS

MGMT

A

trans catheter balloon dilatation needed when pressure gradient across PV markedly increased (>64mmHg)

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