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Flashcards in Cardiology Deck (50):
1

Which syndrome is associated with aortic and pulmonary stenosis?

Williams Syndrome

2

What are the structural features of Tetralogy of Fallot?

VSD
Pulmonary stenosis
RVOT
RVH

3

How do you calculate Pulmonary Vascular Resistance ? (Poiseuille equation)

Mean PA p - LA p
————————-
Pulmonary blood flow (l/min/m2)

4

What is a normal recording for PVR? What is severe and correlates with irreversible pulmonary vascular disease?

Normal PVR = 1-2 u/m2
Severe = > 7.9u/m2

5

How do you calculate Qp (pulmonary blood flow) / Qs (systemic blood flow)

Qp/ Qs = (Ao sat - MV sat)
———————
(PV sat - PA sat)

MV sats: take average of SVC and RA
PV sats: same as LA

6

What is the most common cardiac complication of Duchenne muscular dystrophy?

Dilated cardiomyopathy

7

What congenital cardiac lesion is suggested by a single second heart sound?

Truncal atresia (shared root aorta and pulmonary artery)

8

What cardiac lesion is associated with Turner’s syndrome?

Coarctation of the aorta
Bicuspid aortic valve
Aortic stenosis

9

What cardiac lesion is associated with Di George syndrome?

Tetralogy of Fallot
Truncus Arteriosus

10

What cardiac lesion is associated with Alagille’s syndrome?

Peripheral pulmonary artery stenosis

11

Which cardiac lesion is associated with Noonan’s syndrome?

Valvular pulmonary stenosis

12

What auscultation sign is most indicative of pulmonary hypertension?

Loud S2 (Pulmonary valve closes quicker)

13

Which cardiac malformation is associated with neurofibromatosis?

Pulmonary stenosis

14

Describe the murmur heard for peripheral pulmonary stenosis.

Grade 1-2
Ejection systolic
Left upper sternal edge
Radiating to axilla or back
Benign - due to changes in pulmonary vascular resistance

15

What cardiac malformation would you suspect for a day 2 neonate becoming cyanosed with no other cardiac findings on examination ?

Total Anomalous Pulmonary Vascular Return
Duct dependent

16

Which syndrome is associated with aortic root dilatation?

Turners syndrome

17

What is the cardiac abnormality seen in Alagille syndrome ?

Peripheral pulmonary stenosis

18

What is the most common cardiac abnormality seen in congenital rubella syndrome?

PDA

19

What cardiac abnormalities are seen in Williams syndrome?

Supraaortic valvular stenosis
Peripheral pulmonary stenosis
Systemic arterial stenosis

20

What is the most common cardiac abnormality in velocardiofacial syndrome?

VSD
Right sided aortic arch
TOF

21

What murmur do you hear in TOF?

Harsh ejection systolic murmur over left sternal border (pulmonic area) due to turbulence through R outflow tract
Can also get aortic ejection click, systolic thrill

22

What is the most common complication of surgically corrected TOF?

RBBB (due to widening of RVOT)

23

What are the clinical findings of tricuspid stenosis?

Mid diastolic murmur
Hepatomegaly
Distended neck veins
No respiratory distress

24

What is the most likely diagnosis: cyanosis presenting in first few hours of life
Normal pulse
No respiratory distress
No murmur

TGA

25

What condition is associated with a fixed splitting of the second heart sound?

ASD

26

What is the most common cardiac defect seen in foetal alcohol syndrome?

ASD

27

What are the clinical and ECG/CXR findings for ASD?

Ejection systolic murmur at left upper sternal edge
Fixed splitting of S2
ECG: RBBB
CXR: cardiomegaly, plethoric lungs
(Volume overload right heart)

28

What does upright T wave in V1 indicate? (Age 4 days to 4 years)

Right ventricular hypertrophy

29

Name 2 congenital conditions associated with valvular pulmonary stenosis

Noonans syndrome
Neurofibromatosis

30

Name two syndromes associated with peripheral pulmonary stenosis

Alagille’s
Williams

31

What happens to the murmur of TOF during a tet spell

Gets softer
(Decreased SVR causes reversal of shunt pushing blood back to right side; fixed obstruction across RVOT- less blood flow)

32

What is the event that initiated myocardial fibre contraction ?

Release of stored calcium from sarcoplasmic reticulum

33

Name 5 causes of Pulsus paradoxus

Cardiac tamponade
Constructive pericarditis
Severe asthma
PE
Tension pneumothorax

34

Name 3 congenital cardiac lesions that cause cyanosis and plethoric lungs

TGA
Truncus arteriosus
TAPVR

35

Name 3 cyanotic heart lesions that cause oligaemic lungs

Tetralogy of Fallot
Pulmonary atresia
Ebsteins anomaly

36

Name 5 cyanotic heart lesions that are duct dependent

Hypoplastic left heart
Severe coarctation
Interrupted aortic arch
Severe AS
TAPVR

37

Name 4 acyanotic heart lesions that cause left to right shunting

ASD
AVSD
VSD
PDA

38

In the foetal circulation what is the output from the right ventricle compared to the left ?

RV = 2x LV

39

In foetal circulation what percentage of blood flow passes through the PDA to the descending aorta ?

90%

40

What is the normal pressure for the right ventricle?

25/0mmHg

41

What is the difference between antidromic and orthodromic re-entrant tachycardia

Antidromic = broad complex tachy
Orthodromic = barrow complex tachy

42

Which arrhythmias in WPW require an accessory pathway for maintenance and initiation?

Antidromic and orthodromic re-entrant tachycardia

43

Which arrhythmia in WPW do NOT require an accessory pathway for initiation and maintenance?

AV nodal re-entrant tachy
AF
Atrial flutter
VT
VF

44

What is the most common type of VSD - what % does it account for?

Perimembranous 70%

45

What is the least common type of VSD? What is the main complication?

Type 1
Supracristal / conal
5%
Aortic regurgitation

46

What are the clinical and ECG features of tricuspid atresia ?

Cyanosis day 1
No respiratory distress
Pansystolic murmour left sternal edge
Single S2

ECG:
LEFT ventricular hypertrophy (tall R waves V1, deep S waves V6)

47

How do you calculate pulmonary vascular resistance?

PVR = (Pa - Pv)/Qp

Pa = Pulmonary arterial pressure
Pv = Pulmonary venous pressure = left atrial pressure
Qp = Pulmonary venous flow

48

Specific lung compliance is best standardised by measuring lung compliance at which lung volume ?

Functional residual capacity

49

What are the classes of CFTR mutations in CF?

Class I: no CFTR production
Class II: defective protein processing
Class III: gate malfunction (Ivacaftor)
Class IV: defective conductance of chloride
Class V: Reduced production of CFTR
Class VI: increased turnover at surface of cell

50

What is an associated congenital heart defect with coronary artery fistulae?

Pulmonary atresia with intact septum