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Cardio Flashcards

(51 cards)

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1
Q

what causes a Left to right shunt and presentation?

A

breathless, VSD, ASD, PDA

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2
Q

what causes a right to left shunt and presentation?

A

BLUE. tetralogy of Fallot, transposition of the great arteries.

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3
Q

what causes a common mixing with breathless and blue

A

atrioventricular septal defect

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4
Q

what causes outflow obstruction in a well child- asymptomatic with a murmur

A

pulmonary or aortic stenosis

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5
Q

what causes outflow obstruction in a sick neonate presenting with collapse and shock

A

coarctation of the aorta

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6
Q

what causes the flap of foramen ovale to close

A

change in pressure- left atrial pressure increases and resistance to pulmonary flow decreases so increase of blood through lungs increases by 6 times

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7
Q

how is congenital heart disease found (presentation)

A

antenatal cardiac diagnosis, detection of a murmur, cyanosis, shock, heart failure

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8
Q

what are the signs of an innocent murmur

A

asymptomatic, soft blowing murmur, systolic, left sternal edge. and normal heart sounds, no parasternal thrill, no radiation

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9
Q

what is the presentation of heart failure

A

breathless, sweaty, poor feeding, chest infections. faltering growth, tachypnoea, tachycardia, murmur (gallop), enlarged hart, hepatomegaly, cool peripheries

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10
Q

causes of heart failure

A

neonates- obstruction to left heart; infants- L->R shunt; older children- Eisenmenger, cardiomyopathy

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11
Q

what causes cyanosis in the newborn

A

cardiac- cyanotic congenital heart disease; resp- surfactant deficiency, meconium aspiration; persistent hypertension of the newborn; infection- septicaemia; metabolic acidosis and shock

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12
Q

diagnosis congenital heart disease

A

ECHO, doppler, ECG, chest radiograph

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13
Q

causes of congenital heart disease

A

maternal- diabetes mellitus, rubella, SLE; maternal drugs- warfarin, fetal alcohol syndrome; chromosomal abnormalities- downs, pataus, edwards etc

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14
Q

what is the most common type of ASD

A

ostium secundum

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15
Q

what is the less common type of ASD

A

partial atrioventricular septal defect- ostium primum

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16
Q

what murmur is heard in both types of ASD

A

secundum- ejection systolic, primum- pansystolic

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17
Q

how does ASD present

A

commonly no symptoms, recurrent chest infections/wheeze, arrhytmias

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18
Q

what does the ECG show in ASD

A

secundum- RBBB and RAD, primum- deflected QRS in AVF

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19
Q

what are the signs in ASD

A

ejection systolic (secundum), split S2 due to the right ventricular volume being the same in inspiration and expiration, pansystolic (primum)

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20
Q

management in ASD

A

secundum- cardiac catherisation and occlusion device. primum- surgery. do it by age 3-5 years

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21
Q

what is there a problem with in ostium secundum

Study These Flashcards
A

foramen ovale

22
Q

what does CXR show in ASD

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A

cardiomegaly, enlarged pulmonary artery, increased pulmonary vasculature markings

23
Q

what size is a small VSD

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A

smaller than aorta- less than 3mm

24
Q

symptoms of small VSD

Study These Flashcards
A

asymptomatic, loud pansystolic murmur, quiet pulmomnary second sound

25
management of small VSD
close spontaneously
26
what size is a large VSD
same or bigger than aorta
27
symptoms of large VSD
heart failure- breathless and failure to thrive; recurrent chest infections; tachypnoea, tachycardia, hepatomegaly; SOFT pansystolic murmur, loud P2
28
CXR signs on large VSD
cardiomegaly, enlarged pulmonary arteries, increased pulmonary vasculature markings, pulmonary oedema
29
what is a complication of large VSD
pulmonary hypertension, L to R shunt
30
treatment of large VSD
diuretics, surgery at 3-6m to prevent Eisenmengers
31
what is PDA
where the ductus arteriosus fails to close by 1 month
32
when is PDA common
in pre term infants
33
where is the defect in PDA
between the aorta and pulmonary artery, the blood flows from aorta into pulmonary artery so causing L-R shunt
34
signs in PDA
continuous murmur beneath the left clavicle, collapsing/bounding pulse
35
management PDA
close by coil or occlusion device by 1 year
36
what happens to left ventricle in large left to right shunt
LVH
37
what are the four problems in T of F
overriding aorta, large VSD, pulmonary stenosis, RVH
38
what happens in transposition of the great arteries
aorta is connected to the right ventricle, pulmonary artery is connected to the left ventricle so blue blood goes to the body and pink blood goes back to the lungs
39
when is transposition compatible with life
when there is some mixing- ASD, VSD,PDA
40
symptoms transposition
cyanosis, usually presents day 2 when ductus arteriosus closes and leads to marked reduction in mixing of the blood, usually no murmur but may be a systolic murmur
41
CXR in transposition
egg on side appearance
42
management transposition
maintain patency of DA with prostaglandin. balloon atrial septostomy. surgery- transect pulmonary artery and aorta and switch them over
43
what is Eisenmengers
high pulmonary blood flow and pulmonary hypertension due to large L to R shunt. leads to increased resistance and shunt reversal and the child is blue
44
where is complete atrioventricular septal defect seen
children with Downs
45
what are the features of complete atrioventricular septal defect
cyanosis at birth, breathless at 2-3 weeks of life
46
what is the most common arrhythmia in childhood
SVT rapid HR of 250-300bpm
47
what does SVT lead to and how does it present
leads to poor cardiac output and pulmonary oedema. presents with heart failure symptoms in neonates and young infants and hydrops fetalis and intrauterine death.
48
why is SVT called re rentry tachycardia
circuit of conduction set up, premature activation of atrium via the accessory pathway
49
what is the treatment in SVT
IV adenosine bolus- induces atrioventricular block. electrical cardioversion if this is unsuccessful
50
mainenance therapy in SVT
fleicanide or sotalol. treatment stops at 1 year as more children wont have any further attacks
51
signs of venous hum
continuous low pitched rumble beneath clavicle, increases on inspiration and louder after exercise, disappears when lying flat or compression of jugular veins on ipsilateral side

Paeds (16 decks)

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