Peds - Congenital Cardiovascular Flashcards

1
Q

Which valves are AV?

A

Between ATRIA and VENTRICLES
mitral
tricuspid

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2
Q

Which valves are semilunar?

A

aortic

pulmonic

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3
Q

What causes S1?

A

Closure of the AV valves

mitral
tricuspid

A is the 1st letter, AV make the S1 sound

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4
Q

What causes S2?

A

Closure of the semilunar valves

aortic pulmonic

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5
Q

When does systole occur?

A

Between S1 and S2

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6
Q

When does diastole occur?

A

Between S2 and S1

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7
Q

Generally speaking, what causes S3?

A

Increased fluid states

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8
Q

Generally speaking, what causes S4?

A

Stiff ventricular wall

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9
Q

What does S3 sound like?

A

Kentucky

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10
Q

What does S4 sound like?

A

Tennessee

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11
Q

Which valve is between the R atrium and the R ventricle?

A

Tricuspid

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12
Q

Which valve is between the L atrium and the L ventricle?

A

Mitral

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13
Q

Which valve is between the R ventricle and the pulmonary artery?

A

Pulmonic

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14
Q

Which valve is between the L ventricle and the aorta?

A

Aortic

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15
Q

Pneumonic for order of valves

A

To
Pay
More
Attention

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16
Q
Auscultation area - aortic  
#
A

R upper sternal border

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17
Q
Auscultation area - pulmonic 
#
A

L upper sternal border

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18
Q

Auscultation area - aortic or mitral

A

Apex (Erb’s point)

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19
Q

Auscultation area - tricuspid or VSD

A

L lower sternal border

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20
Q

What might a thrill indicate?

A

VSD

ex: Tetralogy of Fallot

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21
Q

Congenital murmurs tend to be:

A

Systolic

22
Q

Obstructive defects tend to have:

A

Ejection clicks due to turbulence

Referred or radiating sound

23
Q

What is the most common congenital heart defect?

A

VSD

30%

24
Q

Acyanotic lesions shunt which way?

A

Left to Right

25
Q

Cyanotic lesions shunt which way?

A

Right to Left

26
Q

acyanotic defect
systolic murmur @ Left UPPER sternal border
R ventricular hypertrophy

A

Atrial Septal Defect (ASD)

27
Q

acyanotic defect
systolic murmur @ Left LOWER sternal border
may feel a holosystolic THRILL
L ventricular hypertrophy

A

Ventricular Septal Defect (VSD)

28
Q
acyanotic defect
systolic murmur @ Left UPPER sternal border
HOLOSYSTOLIC
"machinery" sound
L ventricular hypertrophy
A

Patent Ductus Arteriosus (PDA)

29
Q
cyanotic defect
(same murmur as VSD but with RVH)

systolic murmur @ Left LOWER sternal border
may feel a holosystolic THRILL

X-ray - “egg on a string”

A

Transposition of the Great Arteries

attempt to maintain PDA

30
Q

cyanotic defect
loud systolic ejection click @ mid and UPPER L sternal border
THRILL #

X-ray - “boot shaped heart”

A

Tetralogy of Fallot

31
Q

obstructive defect
systolic thrill @ R upper sternal border
ejection click which does NOT vary with respiration
L ventricular hypertrophy

A

Aortic Stenosis

32
Q

obstructive defect
systolic murmur @ L upper sternal border
ejection click which DOES vary with respiration
R ventricular hypertrophy

A

Pulmonic Stenosis

33
Q

obstructive defect

A

Coarctation of the Aorta

34
Q

What can be given to stall closure of a PDA (as in the case of cyanotic defects)?

A

Prostaglandins

35
Q

Four defects of Tetralogy of Fallot

A
  • Large VSD
  • pulmonary stenosis
  • overriding aorta
  • RVH
36
Q

What is a “Tet spell” and with which disorder is it associated?

A

Hypercyanotic episode associated with Tetralogy of Fallot

often will squat or sleep in knee chest position to slow return of blood to the heart

periobital edema

37
Q

What are the ACYANOTIC heart defects?

3

A

Atrial Septal Defect

Ventricular Septal Defect

Patent Ductus Arteriosus

38
Q

What are the CYANOTIC heart defects?

2

A

Transposition of Great Arteries

Tetralogy of Fallot

39
Q

What are the OBSTRUCTIVE heart defects?

3

A

Aortic Stenosis

Pulmonic Stenosis

Coarctation of Aorta

40
Q

DiGeorge is associated with which cardiac defect?

A

aortic arch anomalies

41
Q

Down’s syndrome is associated with which cardiac defect?

A

septal defects

42
Q

Edward’s syndrome (Trisomy 18) is associated with which cardiac defect?

A

septal defects <

43
Q

Marfan syndrome is associated with which cardiac defect?

A

aortic regurgitation

mitral valve prolapse

44
Q

Turner’s syndrome is associated with which cardiac defect?

A

coarctation of the aorta

45
Q

Presenting signs and symptoms of child with cardiac defect?

A
cyanosis
exercise intolerance
diaphoresis
edema
clubbing

feeding problems
frequent respiratory infections

tachypnea during sleep
Beck’s triad

46
Q

Beck’s Triad -
includes what?
indication of what?

A

o Lowered BP; widening of pulse pressure
o Distant heart sounds
o Jugular venous distention

Indicates cardiac defect

47
Q

Pulse pressure definition

A

the difference between the systolic and diastolic BP readings

48
Q

Characteristics of innocent murmur

A

No association with failure to thrive or cyanosis
low intensity (grade I-III)
may vary with position
no radiation

49
Q

Why do innocent murmurs occur in up to 50% of children?

A

thin chest wall
more angulated great vessels
more dynamic circulation

50
Q

Most common innocent murmur?
quality?
location?
cause?

A

Still’s Murmur
musical
between L lower sternal border and APEX
caused by turbulence in LV outflow tract

(stiLL’s murmur LL border)

51
Q

Are innocent murmurs systolic or diastolic or both?

A

Only systolic

52
Q

Venous Hum

A
INNOCENT
continuous hum
R upper sternal border
heard best in sitting position
disappears when supine or by turning head/compressing neck ipsilaterally