Paediatric Cardiology - Liam

Question 1

Innocent murmurs

Answer 1

Short, systolic, symptonless

Question 2

Murmur caused by mitral regurgitation

Answer 2

Pan-systolic

Question 3

Murmur caused by tricuspid regurgitation

Answer 3

Pan systolic

Question 4

Murmur caused by ventricular septal defect

Answer 4

Pan systolic

Question 5

Murmur caused by aortic stenosis

Answer 5

Ejection systolic

Question 6

Murmur caused by pulmonary stenosis

Answer 6

Ejection systolic

Question 7

Murmur caused by hypertrophic obstructive cardiomyopathy

Question 8

Murmur caused by atrial septal defect

Answer 8

Mid-systolic, crescendo-decrescendo murmur with fixed split second heart sound

Question 9

Murmur caused by patent ductus arteriosus

Answer 9

May not cause one

Question 10

Tertralogy of fallot murmur

Answer 10

Is due to the pulmonary stenosis, so ejection systolic

Question 11

What is cyanotic heart disease

Answer 11

Cyanosis when deoxygenated blood enters systemic circulation (bypass pulmonary with right to left shunt)

Question 12

4 heart defects that cause cyanotic heart disease

Answer 12

Ventricular septal defect

Atrial septal defect

Patent ductus arteriosus

Transposition of the great arteries

(first 3 usually not unless pressure in right side of heart is far higher than normal)

Question 13

Patent ductus arteriosus

• management

Answer 13

• Monitored with EEG until 1 year old
• Surgical closure if doesnt close spontaneously

Question 14

Atrial septal defect:

• management

Answer 14

• Transvenous catheter closure or open heart surgery
• Anticoagulants (aspirin, warfarin, NOACs) to reduce risk of stroke in adults

Question 15

Eisenmenger syndrome:

• pathology

Answer 15

1. Ventral septal defect causes pulmonary hypertension
2. Increased pressure in right side heart allows shunt from right to left
3. Patient becomes cyanotic - this is Eisenmenger syndrome

Question 16

Ventricular septal defect:

• treatment

Answer 16

• Transvenous catheter closure or open heart surgery
• Increased risk of infective endocarditis so antibiotic prophylaxis during surgery

Question 17

Coarctation of aorta:

• pathology

Answer 17

Narrowing of aortic arach around ductus artiosus

Reduces pressure of blood flowing distal to narrowing, increasing pressure in proximal part (first 3 branches aorta)

Question 18

Coarctation of aorta:

• presentation

Answer 18

• Weak femoral pulses
• High blood pressure in limbs supplied before narrowing

Question 19

Coarctation of aorta:

• management

Answer 19

• Mild can live symptom free until adulthood
• Severe need emergency surgery
• Prostaglandin E to keep ductus arteriosus open while waiting for surgery

Question 20

Tetralogy of fallot:

• 4 abnormalities

Answer 20

1. Ventricular septal defect
2. Overriding aorta
3. Pulmonary valve stenosis
4. Right ventricular hypertrophy

Question 21

Tertalogy of fallot:

• treatment

Answer 21

• Prostaglandin E to keep ductus arteriosis open, then surgery

Question 22

Transposition of great arteries:

• pathology

Answer 22

• Right ventricle pumps into aorta, left into pulmonary

Question 23

Transposition of great arteries:

• treatment

Answer 23

• Prostaglandin to maintain ductus arteriosus
• Balloon septostomy
• Open heart surgery (definitive treatment)

Question 24

Cardiac problem in down syndrome

Answer 24

Atrioventricular septal defect

Question 25

Cardiac problem in turners syndrome

Answer 25

Coarctation of aorta

Question 26

Cardiac problem in 22q11/DiGeorge syndrome

Answer 26

Tertralogy of fallot maybe Pulmonary atresia with ventricular defect

Question 27

Cardiac problem in Williams syndrome

Answer 27

Aortic stenosis

Question 28

Cardiac problem in Noonans syndrome

Answer 28

Pulmonary valve stenosis and hypertrphic cardiomyopathy

Question 29

Cardiac problem in marfans syndrome

Answer 29

Mitral regurgitation

Question 30

Cardiac problem in Long QT syndrome

Answer 30

Ventricular tachycardia or ventricular fibrillation