7.14 Peds Cardio

Question 1

When does the fetal heart begin to beat?

Answer 1

Day 23 after conception

Question 2

Formation of the fetal heart is complete by when?

Answer 2

The 8th week

Question 3

Compare ventricles at birth. Why is this?

Answer 3

Right ventricle is larger than the left due to high pulmonary resistance during fetal life.

Question 4

What limits blood flow into fetal lungs? How is it redirected?

Answer 4

High pulmonary vascular resistance limits flow into the lungs

Redirected through patent ductus arteriosus (PDA)

Question 5

When is the Patent ductus arteriosus closed?

Answer 5

10-15 hours after birth

Question 6

Why is neonatal and infant myocardial muscle less efficient? (2)

Answer 6

• Fewer organized myocardial fibers

- More sensitive to volume pressure overload

Question 7

How do neonate heart sounds compare to those of an adult? (2)

Answer 7

Neonatal heart sounds:

• Higher pitched
• Greater intensity

Question 8

What is the pulse pressure in an infant?

Answer 8

Difference between systolic and diastolic (normally 20 to 50 mmHg)

Question 9

How does Newborn’s heartrate compare to adult’s?

Answer 9

• Higher heart rate (100 to 180)

Question 10

How does Newborn’s respiratory rate compare to that of an adults?

Answer 10

• Higher RR (30 to 40)

Question 11

How does a newborn’s BP compare to that of an adult’s?

Answer 11

75/49 (Lower)

Question 12

Acrocyanosis

Answer 12

Normal finding in infants

Question 13

Vibratory sensation over the precordium, indicated turbulent blood flow is a _____

Answer 13

Thrill

Question 14

A PMI which is diffuse and rises slowly

Answer 14

Heave

Question 15

Where is PMI in newborns / infants? (What does this indicate?)

Answer 15

Left lower sternal border (Indicates RV dominance)

Question 16

In what position should you auscultate the child?

Answer 16

Two: Sitting, reclining

Question 17

What causes S3?

Answer 17

• COMMON in kids and young adults

- Caused by vibrations in the ventricle as it fills rapidly during diastole

Question 18

What does S4 suggest?

Answer 18

• Rare

- Suggests decreased ventricular compliance

Question 19

How are murmurs graded?

Answer 19

Scale from I to VI
(4-6 with a thrill)
Six - audible without stethoscope

Question 20

Murmurs occur in ___% of children

Answer 20

30-50%

Question 21

Six attributes of a pathologic murmur in kids

Answer 21

• Systolic click
• S4 Gallop
• Diastolic or pan-systolic
• Not positional
• Associated with a thrill
• III or above

Question 22

Six attributes of an innocent murmur

Answer 22

• Occurs with S1
• Loudest in Pulmonic area – well located
• Vibratory or musical quality
• Short duration
• Grade III or less intensity
• Variable relationship to position / activity

Question 23

What is the most common Congenital Heart Disesae?

Answer 23

Ventricular Septal Defect (VSD)

Question 24

How are Congenital Heart Defects classified?

Answer 24

Hemodynamic characteristics (Blood Flow)

Question 25

What is a Ventricular Septal Defect?

Answer 25

Opening between right and left ventricle, allowing blood from the higher pressure left ventricle to flow into the right ventricle (leads to right ventricular hypertrophy)

Question 26

What is Tetralogy of Fallot

Answer 26

VSD with Overriding aorta and right ventricular hypertrophy

Question 27

What is Coarctation of the Aorta?

Answer 27

Localized narrowing of the aorta near the ductus arteriosus