Cardiology - PAEDS Flashcards
(13 cards)
What are features of an innocent murmur?
Systolic
Soft
Short
Well localised
30 -50% of school aged children will have a murmur at some point
What are features of a pathological murmur?
Louder
Harsher
Longer
Do not vary with inspiration
Most diastolic murmurs (escept a venous hum)
Associated with features of CCF, orthopnoea, poor feeding or exercise intolerance
What is a common benign cause of syncope in toddlers?
- Breath holding (prolonge forced expiration when crying/upset)
- Reflex anoxic seizure (fright and child holds breath)
What are risk factors for cardiac syncope?
- family hx sudden unexplained death
- no warning
- associated chest pain
- associated palpitations
- during exercise
- while sitting or supine
What would help you differentiate a seizure from anoxic convulsions
Seizure:
- associated with visible cyanosis
- tongue biting
-urinary incontinence
- prolonged period of unconsciousness (anoxic < 60 sec)
- significant disorientation post (post-ictal phase)
What are the congenital cyanotic heart diseases of the newborn ( think 5 T’s)
- Transposition of great vessesls
- Tetralogy of Fallot
- Total anomylouse pulmonary venous return
- Tricuspic atresia
Where do you put your two sats probe to check pre and post ductal sats?
Right hand
Right or left foot
What is the normal cardiothoracic ratio on CXR for a neonate?
< 0.6
What is the dose of prostaglandin E1 for a duct dependent lesion?
5 - 60 ng/kg/min
Side effects: transient respiratory depression and fever
How do you get a kid out of a tet spell?
- Knee to chest
- stop the crying/sympathetic drive: fentanyl IN
- O2 15L/min
- Consider fluid bolus, increase preload
- Put on TLM, monitor BP and sats
What are features of heart failure in an infant?
- failure to thrive
-difficulty feeding/sweats while feeding - recurrent or atpyical respiratory infections, cough
- IWOB
-tachyardia - tachypnoea
What is the dose of IM/IV frusemide?
0.5 - 1 mg/kg
