Cardiology Lecture 3

Question 1

At what point is prostin relevant?

Answer 1

If under 1 month old and suspecting cardiac cause - can be duct dependent problem even at this point

Question 2

Differentials for 18 day old sick child

Answer 2

• Sepsis
• Metabolic - eg pheylketonuria (often present at this stage)
• Cardiac eg coarctation

Question 3

Associations of co-arctation

Answer 3

• Bicupsid aortic valve
• Turners syndrome
• VSD
• Collaterals - radiofemoral delay

Question 4

Signs of heart failure on exam of baby

Answer 4

• Hepatomegaly
• Breathlessness
• Due to L to R shunt - sats will be good

Question 5

Management of HF in baby

Answer 5

• Diuretics
• ACEi
• Fix defect if large enough or pulmonary artery banding

Question 6

What does scrunching knees to chest in a child during a tet spell do?

Answer 6

• Fluid bolus - blood from legs
• Increases systemic vascular resistance

Question 7

Management of tet spell

Answer 7

• O2
• Knees to chest position
• IV fluids
• Morphine - relax infundibulum
• If still not resolving - PICU for esmolol (beta blocker) or phenylephrine

RVOT procedure if still not - stent holding pulomonary artery open

Question 8

Benign causes of cyanosis during crying/getting out of bath

Answer 8

• Breath holding spells
• Acrocyanosis - well otherwise, normal exam, only happens when crying, cold or bath. Self resolves

Question 9

Criteria for IE

Answer 9

• Duke criteria
• Major criteria include +ve BC and vegegtation on valves