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MD 3 - Paeds > cardiology > Flashcards

Flashcards in cardiology Deck (53):
1

treatment of ASD

- 80% close spontaneously
- large defects should be closed surgically before school age

2

typical murmur and heart sounds of an ASD

- ejection systolic murmur, loudest in the left upper sternal border
- fixed splitting of S2

3

Which heart defects are associated with Noonan's syndrome

Pulmonary stenosis
pulmonary branch stenosis

4

Sx of cardiac failure in infants

- feeding difficulties
- early fatiguability
- diaphoresis while sleeping/eating
- respiratory distress
- lethargy
- FTT

5

treatment of a patient with coarctation of the aorta

- medical - prostaglandin E2 in neonates (to reopen the ductus arteriosus)
- surgery or catheter

6

which major congenital heart diseases cause high pulmonary blood flow

ventricular septal defect
atrial septal defect
patent ductus arteriosus

7

at what age is the most likely time you will hear a Still's murmur

2-6 years

8

classic venous hum murmur

- low pitch continuous murmur
- maximal over the upper sternal edges, but often R>L
- louder when erect
- quieter when head turned away or jugular vein compression

9

which Congenital heart disease is associated with fixed splitting of S2

atrial septal defect

10

the figure 3 sign is suggestive of

coarctation of the aorta

11

4 main types of innocent murmur

still's murmur
pulmonary flow murmur
branch pulmonary stenosis
venous hum

12

4 key findings on examination of a child in heart failure

tachycardia
tachypnoea
cardiomegaly
hepatomegaly

13

4 components of tetralogy of fallot

- ventricular septal defect
- pulmonary stenosis
- over-ride of the aortic valve
- right ventricular hypertrophy

14

haemodynamic consequence of TOF

right to left shunting

15

treatment of TGA

- prostaglandins to maintain ductal patency
- balloon atrial septostomy ASAP
- arterial switch surgery in first 2 weeks

16

which congenital heart disease is associated with a delay in P2

pulmonary stenosis

17

which VSD location has the highest rate of spontaneous closure

muscular

18

what are the 3 locations that a VSD can be in

perimembranous
muscular
double committed

19

innocent murmurs always:

- are systolic
- vary with position
- vary with respiration
- have normal heart sounds

20

what is the Eisenmenger complex

pulmonary vascular resistance changes caused by CHD may be irreversible at ~1 year

21

main DDx you want to exclude when you think you hear a venous hum

patent ductus arteriosus

22

typical heart sounds of a patient with a patent ductus arteriosus

- continuous machinery murmur that obliterates the second heart sound heart best below the left clavicle

23

at what age is the most likely time you will hear a pulmonary flow murmur

children-adolescents

24

at what age is the most likely time you will hear a branch pulmonary stenosis murmur

infants

25

classic murmur and heart sounds of pulmonary stenosis

- ejection systolic murmur with an ejection click, loudest at the left upper sternal edge
- radiation to back
- delay in P2

26

classic branch pulmonary stenosis murmur

- systolic murmur radiating to the axilla and back

27

management includes prostaglandin infusion and balloon atrial septosomy

TGA

28

which VSD location has the lowest rate of spontaneous closure

double committed

29

haemodynamic consequence of a large VSD

volume loading of the left ventricle and increased pulmonary blood flow --> decreased pulmonary compliance --> increased WOB

30

which heart defects are associated with Down syndrome

AVSD
VSD

31

classic still's murmur

- musical hum
- early to mid systolic
- crescendo then decrescendo
- maximal over the LLSE
- disappears when erect and audible when erect

32

when would you give medical treatment over surgical treatment for a large VSD

usually to defer surgery in very small infants until slightly older

33

which heart defects are associated with Turner's syndrome

coarctation of the aorta

34

2 major cyanotic congenital heart diseases

tetralogy of fallot
transposition of the great arteries

35

clinical presentation of TGA

severe progressive cyanosis developing over first days of life

36

typical clinical presentation of a patient with coarctation of the aorta

- tachypnoea
- weak or absent femoral pulses
- radio-femoral delay
- classic murmur
- marked discrepancy between BP of arms and legs

37

classical murmur and heart sounds of a ventricular septal defect

- harsh pan-systolic murmur heart best over the left lower sternal border
- thrill

38

which congenital heart disease has associations with other heart defects

coarctation of the aorta

39

typical murmur and heart sounds of a patient with coarctation of the aorta

- continuous murmur heard over the back

40

treatment of pulmonary stenosis

first line - catheter
second line - surgery

41

treatment of a PDA

- medical = indomethacin in a premature infant
- majority will close spontaneously
- surgery for symptomatic infant

42

classic pulmonary flow murmur

- ejection to mid systolic
- medium to high pitch
- maximal over the 2-3rd intercostal in the LUSE

43

treatment of TOF

always surgical

44

common location for an atrial septal defect

in the region of the fossa ovalis

45

clinical presentation of TOF

- intermittent cyanosis over 6-12 months often not obvious in newborn period
- hypercapnic spells

46

typical murmur and heart sounds of TOF

- Harsh ejection systolic murmur audible at the left sternal edge radiating to the back
- second heart sound is often quite loud

47

which heart defects are associated with foetal alcohol syndrome

ASD
VSD
TOF

48

typical clinical presentation of a patient with an ASD

- not until the 3rd or 4th decade
- Right heart symptoms

49

typical clinical presentation of a large PDA

- present around 4 weeks
- weight gain
- tachypnoea
- collapsing pulses
- wide pulse pressure

50

which Congenital heart disease murmurs can be heart on the back

coarctation
pulmonary stenosis
TOF

51

which congenital heart disease is the most common

ventricular septal defect

52

haemodynamic consequence of an ASD

volume loading of the right ventricle and increased pulmonary blood flow --> decreased pulmonary compliance --> increased WOB

53

pulmonary flow murmurs need to be further investigated to rule out which DDx

pulmonary stenosis
atrial septal defect