Paediatric Cardiology

Question 1

where does the ductus venosus connect?

Answer 1

the umbilical vein to the IVC

Question 2

What regulated the blood flow through the ductus venosus

Answer 2

a sphincter

Question 3

Where does the ductus arteriosis connect?

Answer 3

the pulmonary arteries to the aorta

Question 4

What is the foramen ovale?

Answer 4

A hole which diverts blood from the right atrium to the left atrium

Question 5

What happens to faeotal circulation at birth?

Answer 5

ductus venosis and arteriosis, foramen ovale and the umbilical vessels close off ductus venosus sphincter constrics, diverting blood to the liver

Question 6

what adult structure arises from the foramen ovale?

Answer 6

the fossa ovalis

Question 7

what adult structure arises from the umbilical vein?

Answer 7

ligamentum teres (liver)

Question 8

what adult structure arises from the ductus venosus?

Answer 8

ligamentum venosum

Question 9

what adult structure arises from the ductus arteriosus

Answer 9

ligamentum arteriosis

Question 10

What are the two mechanisms by which a new born can have an atrial septal defect?

Answer 10

Patent Foramen ovale Septum irregularity

Question 11

In atrial septal defects What are the two types of septum irregularity ?

Answer 11

Primum and Secundum

Question 12

Are atrial septal defects cyanotic or non-cyanotic?

Answer 12

non-cyanotic

Question 13

What 2 symptoms can an adult present with who had an atrial septal defect?

Answer 13

cough or hypertensive episode

Question 14

Which direction does the shunt go in a small atrial septal defect?

Answer 14

from L to R because of higher pressure on the left heart

Question 15

In ASD why can the shunt change from L to R -> R to L? and what is this called?

Answer 15

blood initially moves from left to right because of the ASD, after long enough the right heart pressure becomes higher than the left heart pressure. Eissenmengers and is now cyanotic

Question 16

What will you hear on auscultation of an ASD?

Answer 16

Fixed splitting of S2

Question 17

What will you see on ECG in ASD?

Answer 17

prolonged PR

Right axis deviation

Question 18

What disease are ventricular septal defects associated with

Answer 18

Down’s Syndrome

Question 19

What three signs will be seen in an infant with a VSD?

Answer 19

breathlessness

poor feeding

failure to thrive

Question 20

What condition can lead to a VSD in an adult?

Answer 20

MI

Question 21

What will be heard on aiscultation of a child with a VSD?

Answer 21

Pansystolic murur

Question 22

What will be seen on ECG of a child with a VSD?

Answer 22

Right axis deviation

Question 23

What is the management of a VSD?

Answer 23

Conservative

Medical - Digoxin, diuretics

Surgery

Question 24

What illness in pregnancy is assocciated with a patent ductus arteriosis?

Answer 24

Rubella during early pregnancy

Question 25

What children are most likely to have a patent ductus arterisosis?

Answer 25

Pre-term infants due to hypoxia and immaturity

Question 26

What murmur us associated with patent ductus arteriosis and where is it best heard?

Answer 26

machine like murmur best heart below the left clavicle

Question 27

how are patent ductus artrisosis treated?

Answer 27

medical - fluid restrict and Prostaglandin synthase inhibitors (indomethacin) Surgical closure

Question 28

What is corarctation of the aorta?

Answer 28

kinking of the aortic arch

Question 29

Why might an aortic coarctation not be noticed for a while in pre-term infants?

Answer 29

Symptoms may not show until a patent ductus arteriosis closes, therefor synthetic prostaglandins may be given to prevent PDA closing

Question 30

What two other cardiac birth defects may be present in a child with aortic coarctation?

Answer 30

VSD or bicuspid valve

Question 31

What will be on auscultation in aortic coarctation?

Answer 31

ejection systolic murmur best heard between the shoulder blades

Question 32

What will be seen on ECG in aortic coarctation?

Answer 32

Ventricular hypertrophy (first L then R) R wave progression

Question 33

What is an interrupted aortic arch?

Answer 33

NO connection between the proximal and distal sides of the aorta. Must be a PDA to let blood flow to defending aorta?

Question 34

What congenital condition is associated with an interrupted aortic arch?

Answer 34

Di George's

Question 35

What is Di Georges syndrome?

Answer 35

Di Georges syndrome is an autosomal dominant condition characterised by congenital heart defects such as interruption of aorta and tetrology of Fallot, no thymus, hypocalcaemia and palatal defects.

Question 36

What are the There cyanotic heart defects?

Answer 36

Tetraology of Fallot Transposition Tricuspid atresia (eisenmenger's)

Question 37

What are the non-cyanotic heart defects? (5)

Answer 37

ASD VSD PDA aortic coarctation aortic interuptions

Question 38

What are the 4 key abnormalities in tetralogy of Fallot?

Answer 38

VSD Obstruction of blood flow from right ventricle to lungs Aorta lies directly over the ventricular septal defect Right ventricular hypertrophy

Question 39

Describe tetraology of fallot

Answer 39

Question 40

What does tetrology of fallot cause clinically?

Answer 40

Mixing of blood Poor blood flow to lungs Poor quality of blood to body **BLUE BABY**

Question 41

What is the characteristic sign on CXR in tetralogy of fallot?

Answer 41

Coeur-en-sabot (boot shaped heart)

Question 42

What is the management of tetralogy of fallot?

Answer 42

B-blockers adreneline phone senior may be palliative surgical procedure (either shunt from PA to aorta or repair)