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Paediatrics > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

S+S of innocent murmur

A

Asymptomatic

Soft blowing murmur

Systolic only

Left sternal edge

Localised - no radiation

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2
Q

Congenital heart abnormalities with Downs, Turners + Marfans

A

Downs = ASD/ AVSD (only Downs get AVSD)

Turners = coarctation of aorta

Marfans = aortic aneurysm

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3
Q

What maternal factor can cause congenital heart disease?

A

Drugs: warfarin, phenytoin Alcohol DM SLE

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4
Q

What is the pathology of Fallots?

A

Right to left shunt Pulmonary stenosis, right ventricular hypertrophy, ventricular septal defect, overriding aorta

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5
Q

S+S Fallots

A

Cyanosis at rest + on exertion Cyanotic attacks - SOB + cyanosis

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6
Q

Management of Fallots

A

O2, beta blockers + analgesia Surgery

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7
Q

ASD pathology

A

Left to right shunt Can cause HF due to high pulmonary blood flow

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8
Q

ASD S+S

A

SOB Cyanosis Asymptomatic in childhood - symptoms in 20s + 30s Pulmonary hypertension, HF + atrial dysrhythmias

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9
Q

VSD murmur

A

Pansystolic murmur at left sternal edge

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10
Q

What is Eisenmenger’s syndrome?

A

Without surgery for VSD, pulmonary vascular disease worsens Shunt reverses Cyanosis + SOB

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11
Q

Patent ductus arteriosus S+S

A

Small PDAs – asymptomatic. Large PDAs = FTT, recurrent LRTIs

Continuous machinery murmur loudest in infraclavicular area or left sternal edge

Bounding pulse + systolic thrill

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12
Q

S+S coarctation

A

SOB, grey

Systolic murmur loudest in left infraclavicular area, radiating into back. Weak femoral pulses

Hepatomegaly, BP lower in legs than arms

Critical stenosis in neonates – cold + cyanotic legs, no femoral pulse

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13
Q

Management of coarctation

A

Prostaglandin E to reopen ductus Surgery

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14
Q

What is transposition of the great vessels?

A

Oxygenated blood = pulmonary artery Deoxygenated venous blood = aorta Right to left shunt

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15
Q

Signs of transposition

A

Cyanosis SOB Poor feeding

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16
Q

X ray signs of transposition

A

Heart has narrow pedicle like an egg

17
Q

What is a flow murmur?

A

Type of innocent murmur

HR + blood flow increased due to response to increase O2 demand (ie illness)

Turbulent blood flow = audible murmur, loudest at left sternal edge

18
Q

What is a venous hum?

A

Type of innocent murmur

drainage of blood through jugular veins causing vibration + hum of vessel walls

loudest beneath the clavicle

obliterated when lying flat

19
Q

What investigations are required when a murmur is found?

A

Innocent - no investigations but follow up with GP when well

Echo if there are any red flags (cyanotic, FTT, difficulty breathing + feeding, HF)

20
Q

When should a PDA close + what is the management?

A

PDA closes on day 1-2 of life, disappears by 3 weeks

Echo to confirm diagnosis

Wait up to a year to close if asymptomatic then catheter closure

Symptomatic pts:

  • Ibuprofen (preterm), indomethacin, paracetamol
  • Diuretics for HF
  • Surgical ligation
21
Q

RF for PDA

A

preterm, Downs, females, congenital rubella, maternal valproate exposure

22
Q

Where is coarctation of the aorta + what are the complications?

A

Usually distal to subclavian artery, near ductus arteriosus.

Causes proximal hypertension, ventricular hypertrophy + HF

23
Q

RF for coarcation

A

Turners, males, fam hx

24
Q

Management of coarcation

A

prostaglandins, diuretics for HF, anti-hypertensives if needed. Surgery

25
Q

What is the most common form of congenital heart disease?

A

VSD

26
Q

RF for VSD

A

trisomies, maternal diabetes, turners, foetal alcohol syndrome

27
Q

Where does a VSD occur + how does it progress?

A

Starts as a left ventricular hypertrophy + then leads to right ventricular hypertrophy

Usually in perimembranous area

28
Q

S+S of mild, mod + severe VSD

A

Small VSD – asymptomatic, pansystolic murmur at LSE

Mod VSD – SOB on feeding from 5-6 weeks, increased WOB + FTT

Large VSD – irreversible pulmonary hypertension + cyanosis

29
Q

Management of VSD

A

Most VSDs close by 2 years. If not closed by 5, surgically close

Management if symptomatic:

  • Diuretics + high calorie feeds
  • Surgical – open heart surgery or catheter closure – do it around 6 months
30
Q

What are the congenital cyanotic defects?

A

TOF, transposition of arteries

31
Q

What are the congenital acyanotic defects?

A

ASD + AVSD

32
Q

When should TOF be fixed?

A

6 months

33
Q

What are the acquired heart defects?

A

coronary artery aneurysms (Kawasakis),

carditis/ mitral valve disease (rheumatic fever)

34
Q

What is a tet spell?

A

Occurs with TOF - child goes blue on exertion, squats to relieve it (knees to chest to help increase venous return to the heart)

Paediatrics (19 decks)

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