Paeds: Cardio and other things I get wrong

Question 1

What are the acyanotic heart conditions in children? How do you differentiate them with heart sounds

Answer 1

Atrial septal defect: Ejection systolic
Ventricular septal: Pansystolic (loud if small, quiet if large)
Patent ductus arteriosus: Diastolic murmur + collapsing pulse
Coarctation of aorta: Mid-systolic murmur + apical click

Question 2

What are the cyanotic heart conditions in children? How do you differentiate them?

Answer 2

Tetralogy of fallot: Ejection systolic murmur
Transposition of the great arteries: Loud S2
Tricuspid atresia

Question 3

What investigations are performed for suspected paeds heart conditions?

Answer 3

1. CXR
2. Echo
   + ECG

Question 4

CXR showing increased heart and pulmonary artery size, increased pulmonary markings describes what paeds heart condition?

Answer 4

atrial septal defect OR ventricular septal defect

Question 5

How does atrial and ventricular defect differ on ECG?

Answer 5

ASD: RBB in secundum, RAD due to ventricular enlargement
VSD: Upright T-wave in V1

Question 6

What condition do you give the following as first line therapy?
NSAIDs
PGE 1 (alpostadil)
B-blockers

Answer 6

NSAIDs: PDA
PGE1: Coarctation of the aorta
B-blockers: Tetralogy of Fallot

Question 7

What makes up the tetralogy of Fallot

Answer 7

Tetralogy of Fallot

• Ventricular Septal Defect
• Right Ventricular Hypertrophy and obstruction
• Pulmonary stenosis
• Overriding aorta

Question 8

Which paeds cardio condition has the following CXR findings
Boot shaped heart
‘Egg on side’

Answer 8

Tetralogy of Fallot

Transposition of the great arteries

Question 9

Children under what percentile should be referred to paeds?

Answer 9

0.4

Question 10

In neonatal hypoglycaemia, how do you decide what treatment to give the child?

Answer 10

no symptoms: Encourage feeds + monitor

Symptoms: Admit for 10% IV dextrose