Cardiac Flashcards by Catie Straut

upper chambers of heart

atria

low pressure receiving chambers

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lower chambers of the heart

ventricles

high pressure pumping chambers

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The ___ receives deoxygenated blood from the body

right atrium

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The ___ pumps deoxygenated blood through the pulmonary artery to the lungs to become oxygenated

right ventricle

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The ___ receives oxygenated blood from the lungs

left atrium

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The ___ pumps oxygenated blood from the lungs out the aorta and into the body

left ventricle

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Functional closure of the PDA occurs at

48-72 hours after birth

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Complete closure of the PDA occurs at

2-3 weeks

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Heart forms in the fetus by the ___ week after conception

third

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By day ___ of conception the heart begins to beat

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Heart formation in the fetus is complete by the ___ week after conception

8th

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AV valves, location

tricuspid valve (on the right)
mitral valve (on the left)

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Semilunar valves, location

pulmonic valve (at the base of the pulmonary artery between the right ventricle and the pulmonary artery)

aortic valve (base of the aorta between the aorta and the left ventricle)

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Infants with CHD may have tachypnea and tachycardia but typically do not present in ____ unless there is a significant increase in pulmonary blood flow or poor systemic output with acidosis

respiratory distress

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___ are usually normal with CHD except for color if cyanotic

Apgar scores

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Symptoms of ___ usually occur with feeding because of increased oxygen consumption and need for greater cardiac output

feeding

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Blood pressure in infants should be taken where?

In all four extremities

At minimum in the right arm and in one leg to detect COA

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In children, simultaneous palpation of which 2 pulses is important in assessing whether a coarctation is present?

Radial and femoral

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What might pallor in an infant indicate?

Anemia

CHF

Shock

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Children with cyanotic heart disease will appear blue/ruddy particularly around what area?

Perioral area

b/c of right-to-left shunting of blood at arterial level

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___ occurs when arterial desaturation has been present for at least 6 months of longer

Clubbing

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A pulse that’s absent or weaker in the lower extremities compared to the upper extremities is diagnostic of what condition?

COA

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Normal liver size

1 to 2cm below the right costal margin

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In conditions of abnormal cardiac position, where is the liver edge?

Midline or on the left side of the abdomen

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Where is PMI normally palpated? What about in infants and newborns?

apex in the left mid-clavicular line left lower sternal border (infants/newborns)

S1 is created by the closure of what two valves? Where is it best heard?

closure of tricuspid and mitral best at LLSB or apex

S2 is created by the closure of what two valves? Where is it best heard?

aortic and pulmonic left upper sternal border

The origin of a murmur is usually found at what point?

Where it's heard the loudest

___ due to cardiac cause is rare, occurring in less than 4% of cases

Chest pain

Where is PMI in infants?

4th intercostal space

Where is PMI in children over 7?

5th intercostal space

large, laterally displaced PMI would indicate

cardiomegaly

Thrills are best assessed with what part of the hand?

supine (not fingertips)

Carotid thrill indicates what condition?

aortic stenosis

Surpasternal notch thrill could be an indication for what 3 conditions?

Aortic stenosis, PDA, coarctation

RUSB (right upper sternal border) thrill indicates what condition?

Aortic stenosis

LUSB thrill indicates what condition?

Pulmonary stenosis

LLSB thrill indicates what condition?

VSD

Apex thrill indicates what condition?

Mitral regurgitation

Size of liver with cardiac stuff indicates what?

Fluid status - the more congested/fluid-filled, the lower down the liver will be

5 main red flags with HPI on cardiac patients

1. FTT: feeding issues, poor weight gain 2. Dyspnea/exercise intolerance 3. Frequent respiratory infections 4. Excessive weight gain (fluid?) 5. Older children: HTN/new onset murmur

Stethoscope diaphragm is to listen for high-frequency sounds such as (6):

``` S1 S2 clicks MR and AR murmurs small VSDs rubs ```

Stethoscope bell is to listen for low-frequency sounds such as (4):

S3 S4 MS murmur defects with increased flow across AV valves

Clicks are usually what?

mechanical valve closing

What does a rub sound like? What does it mean?

Sandpaper (or what a chest tube sounds like) Inflammation around the heart's lining

How do you treat a rub?

Round-the-clock Motrin for 5-7 days

Aortic area of auscultation

2nd ICS, right sternal border

Pulmonic area of auscultation

2nd ICS, left sternal border

If aortic and pulmonic valves do not close at the same time it's called a ____

split

Tricuspid area of auscultation

5th ICS, left sternal border

Mitral area of auscultation

5th ICS, left mid-clavicular line

PDA is normally considered a non-cyanotic condition, but when can it be cyanotic as well?

PDA can be cyanotic as well if pulmonary hypertension develops when the high pressure aortic pumps blood into the pulmonary trunk

Cyanotic or Noncyanotic: VSD

Noncyanotic

Cyanotic or Noncyanotic: ASD

Noncyanotic

Cyanotic or Noncyanotic: PDA

Noncyanotic (can also be cyanotic tho)

Cyanotic or Noncyanotic: Pulmonary stenosis

Noncyanotic

Cyanotic or Noncyanotic: Aortic stenosis

Noncyanotic

Cyanotic or Noncyanotic: AV canal

Noncyanotic

Cyanotic or Noncyanotic: Coarctation of the aorta

Noncyanotic

Cyanotic or Noncyanotic: Ebstein’s Anomaly

Cyanotic

Cyanotic or Noncyanotic: HLHS

Cyanotic

Cyanotic or Noncyanotic: Pulmonary atresia

Cyanotic

Cyanotic or Noncyanotic: Tetrology of Fallot

Cyanotic

Cyanotic or Noncyanotic: TAPVR

Cyanotic

Cyanotic or Noncyanotic: TGA

Cyanotic

Cyanotic or Noncyanotic: Truncus Arteriosus

Cyanotic

Cyanotic or Noncyanotic: Tricuspid atresia

Cyanotic

DiGeorge syndrome is associated with what cardiac defects? (4)

Interrupted aortic arch, Truncus arteriosus, TOF, VSD

Trisomy 21 is associated with what cardiac defects? (3)

AV canal defect, ASD, PDA

Marfan syndrome is associated with what cardiac defect?

aortic root enlargement

Noonan syndrome is associated with what cardiac defects?

PS or hypertrophic cardiomyopathy

Trisomy 13 is associated with what cardiac defects? (3)

ASD, VSD, PDA

Turner syndrome is associated with what cardiac defects? (2)

aortic valve stenosis, coarctation of aorta

2 events in systole

1. isovolumetric ventricular contraction | 2. ventricular ejection

2 events in diastole

1. isovolumetric ventricular relaxation | 2. atrial contraction

Is a split S1 normal in children?

Yes - not affected by respiration

When is a split S2 normal in children?

During inspiration This is because increased venous return to right side of heart leads to slower contraction of RV

When is a split S2 pathologic in children?

During expiration This would be a sign of aortic stenosis or cardiomyopathy

Loud Aortic S2 could indicate

arterial hypertension

Loud Pulmonic S2 could indicate

pulmonary hypertension

Fixed or widely split S2 could indicate what 3 events:

Late closure of pulmonic valve (ASD, Pulmonary stenosis) Early closure of aortic valve (Severe MR) Late closure of aortic valve (AS)

S3: Ventricular gallop from rapid ventricular filling is common in what 3 defects

MR, TR, Heart failure

S4: Atrial gallop is common in what 3 defects

Aortic stenosis, cardiomyopathy, or heart block

Non-ejection clicks:

Mitral valve prolapse

Opening snap:

Sharp, high frequency sound after S2 Mitral stenosis

Aortic ejection click is heard where? What does it indicate?

LLSB Aortic stenosis

Pulmonic ejection click is heard where? What does it indicate?

LUSB Louder with expiration Pulmonary stenosis or pulmonary hypertension

4 main examples of continuous murmurs

1. **holosystolic murmur (seen in VSD) 2. PDA 3. BT shunt (single ventricle patients, post-Norwood) 4. AV malformation

____ is most common innocent murmur

Still’s murmur

Type I TAPVR looks like what on x-ray?

Snowman

TOF looks like what on x-ray?

Boot

Partial anomalous pulmonary venous return looks like what on x-ray?

Sword

Transposition of the great arteries looks like what on x-ray?

Egg on a string

Infants with serious cardiac disease present early with (3):

1. Congestive heart failure and pulmonary edema 2. Cyanosis (central, differential) 3. Shock

Cardiac Flashcards

(94 cards)