Cardio Flashcards Preview

Paeds > Cardio > Flashcards

Flashcards in Cardio Deck (51):
1

what causes a Left to right shunt and presentation?

breathless, VSD, ASD, PDA

2

what causes a right to left shunt and presentation?

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

3

what causes a common mixing with breathless and blue

atrioventricular septal defect

4

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

pulmonary or aortic stenosis

5

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

coarctation of the aorta

6

what causes the flap of foramen ovale to close

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

7

how is congenital heart disease found (presentation)

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

8

what are the signs of an innocent murmur

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

9

what is the presentation of heart failure

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

10

causes of heart failure

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

11

what causes cyanosis in the newborn

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

12

diagnosis congenital heart disease

ECHO, doppler, ECG, chest radiograph

13

causes of congenital heart disease

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

14

what is the most common type of ASD

ostium secundum

15

what is the less common type of ASD

partial atrioventricular septal defect- ostium primum

16

what murmur is heard in both types of ASD

secundum- ejection systolic, primum- pansystolic

17

how does ASD present

commonly no symptoms, recurrent chest infections/wheeze, arrhytmias

18

what does the ECG show in ASD

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

19

what are the signs in ASD

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

20

management in ASD

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

21

what is there a problem with in ostium secundum

foramen ovale

22

what does CXR show in ASD

cardiomegaly, enlarged pulmonary artery, increased pulmonary vasculature markings

23

what size is a small VSD

smaller than aorta- less than 3mm

24

symptoms of small VSD

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