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3A > Paeds - Cardiology > Flashcards

Paeds - Cardiology Flashcards

1
Q

Physiological murmur

Features and investigations

A

InnoSent

Soft
Systolic
aSymptomatic
left Sternal edge

Investigations

  • Antenatal - ECHO
  • Neonatal - ECHO, ECG, CXR
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2
Q

Left to right shunts

A

ACYANOTIC

Increased pulmonary flow

  • ASD
  • VSD
  • PDA

Obstructed flow from ventricles

  • Aortic stenosis
  • CoA
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3
Q

Right to left shunts

A

CYANOTIC

Mixed flow

  • ToF
  • ToGV
  • HLHS
  • Tricuspid atresia

Decreased pulmonary flow
- Pulmonary atresia

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4
Q

Left to right shunt features

A

ACYANOTIC
Blood is oxygenated but cannot circulate

Tachypnoea
FTT
Poor feeding

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5
Q

Right to left shunt features

A

CYANOTIC
Blood is not getting to the lungs so deoxygenated

CCCA
Cyanosis 
Collapse 
Clubbing 
Acidosis
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6
Q

Duct dependent lesions

A

Immediate prostaglandin infusion required to maintain PDA - Usually closes on day 2

CoA
HLHS
ToGV
ToF

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7
Q

Causes of congenital heart defects

A

DAD GINUS

Diabetes 
Alcohol 
Drugs - SSRI / DMARD / Warfarin 
Genetics 
Infection - Rubella 
NCC dysregulation
Unknown
Syndrome
- DiGeorge - ToF and TA
- Downs - ASD, VSD, ToF
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8
Q

What is ToF

A

Right to left shunt - Cyanotic

  1. Pulmonary stenosis
  2. Overriding aorta
  3. VSD
  4. RV hypertrophy

Associated with

  • Di George
  • Downs
  • Turners
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9
Q

ToF presentation

A

Cyanosis
Clubbing
Collapse
Acidosis

Tet spells - White and floppy
INCONSOLABLE CRYING
Squatting sign

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10
Q

ToF investigations

A

EJECTION SYSTOLIC MURMUR - ULSE

CXR

  • Boot shaped heart
  • Decreased pulmonary vascular markings
  • ECHO
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11
Q

ToF management and complications

A

Maintain PDA
Prostaglandins - Alprostadil

Surgical correction at 6 months

Complications

  • CCF
  • Endocarditis
  • MI
  • CVA
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12
Q

ToGV aetiology and clinical features

A

Transposition of the great vessels
Septum of truncus arteriosus fails to spiral

Cyanosis
Clubbing
Collapse - Day 2 - Closure of PDA
Acidosis

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13
Q

ToGV investigations and management

A

Loud S2
CXR - Egg on side
No murmur

Maintain PDA - Prostaglandins

Surgical repair

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14
Q

Tricuspid atresia

A

Cyanotic

Blood cannot enter RV

Management - Blalock Taussig shunt

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15
Q

Hypoplastic left heart syndrome

A

Cyanotic

Circulatory collapse

Management

  • Prostaglandins
  • Surgical repair
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16
Q

PDA aetiology and presentation

A

ACYANOTIC

Failure to close 1 month after EXPECTED delivery date

Tachypnoea 
FTT 
Poor feeding 
Hepatomegaly 
Oedema
17
Q

PDA investigations

A

MACHINE MURMUR - Below left clavicle

Gallop
Thrill
Bounding pulse
Collapsing pulse

CXR

18
Q

PDA management and complications

A

NSAIDs - Indomethacin

Surgical ligation

Eisenmenger’s
Endocarditis
HF
Pulmonary HTN

19
Q

VSD presentation

A

Tachypnoea
FTT
Poor feeding

HF
Wheeze

Hepatomegaly

Small - LOUD pansystolic murmur
Large - QUIET

20
Q

VSD investigations / management / complications

A

CXR
TTE

Small - Spontaneous closure

Large

  • Diuretics - Captopril
  • Surgical closure

Complications

  • Aortic regurgitation
  • Endocarditis
  • Eisenmenger’s
  • HF
  • Pulmonary HTN
21
Q

ASD presentation

A

Tachypnoea
Poor feeding FTT

Wheeze
Recurrent chest infections
Arrhythmias - 4th decade

22
Q

ASD investigations and management

A

Wide split S2
Ejection systolic murmur - ULSE

CXR
ECG
TTE

Small - Spontaneous closure

Large - Cardiac catheterisation

23
Q

PDA/ASD/VSD

CXR findings

A

Enlarged pulmonary vessels
Increased pulmonary vasculature
Cardiomegaly

24
Q

CoA aetiology and presentation

A

Associated with

  • DiGeorge
  • Turner’s

Outflow obstruction in a sick child

Circulatory collapse on day 2

SOB
Intermittent claudication
Arterial HTN

25
Q

CoA investigations / management / complications

A

Ejection systolic murmur - ULSE
Murmur heard over back

Radio-radial / radio-femoral delay

CXR

  • Rib notching
  • 3 sign

Management

  • Prostaglandins
  • Surgery

Complications - IC haemorrhage - Upper body HTN ^^^

26
Q

Aortic stenosis aetiology and presentation

A

Associated with - William’s syndrome

Outflow obstruction in a well child

SAD

  • Syncope
  • Angina / chest pain
  • Death

Carotid thrill

27
Q

Aortic stenosis / Pulmonary stenosis investigations and management

A

AS

  • Ejection systolic murmur - URSE
  • Downward T wave in V6

PS

  • Ejection systolic murmur - ULSE
  • Palpable thrill
  • Upright T wave in V1

Management - Balloon dilatation

3A (31 decks)

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