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Peds Cardiac Flashcards

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1
Q

congenital heart dz –> CXR –> eval which structures? (2)

A
  • pulm vasculature

- heart size

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2
Q

congenital heart dz –> CXR –> eval pulm vasc –> 3 types?

A
  • increased pulm venous flow
  • increased arterial flow
  • decreased arterial flow
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3
Q

congenital heart dz –> CXR –> pulm vasc –> increased pulm venous flow –> imaging appearance?

A

peripheral 1/3 –> indistinct vessels & septal markings

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4
Q

congenital heart dz –> CXR –> pulm vasc –> increased pulm venous flow –> can be seen in what conditions? (4)

A
  • hypoplastic L heart
  • aortic coarctation
  • congestive heart failure
  • neonatal sepsis
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5
Q

congenital heart dz –> CXR –> pulm vasc –> increased arterial flow –> imaging appearance?

A

peripheral 1/3 –> distinct lrg-caliber vessels

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6
Q

congenital heart dz –> CXR –> pulm vasc –> increased pulm arterial flow –> can be seen in what conditions? (4)

A

L-to-R shunt:

  • atrial septal defect
  • VSD
  • patent ductus arteriosus
  • endocardial cushion defect (AV canal defect)
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7
Q

congenital heart dz –> CXR –> pulm vasc –> decreased arterial flow –> imaging appearance?

A

peripheral 1/3 –> decreased vasculature

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8
Q

congenital heart dz –> CXR –> pulm vasc –> decreased pulm arterial flow –> can be seen in what conditions? (2)

A

RV outflow tract insuff:

  • Tetralogy of Fallot
  • Ebstein anomaly
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9
Q

increased pulm venous flow –> aka?

A

pulm edema

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10
Q

extra-cardiac AV shunt –> 2 examples? (2)

A
  • vein of Galen malformation

- infantile hepatic hemangioma

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11
Q

neonatal CHF –> etiology? (2)

A
  • primary cardiac anomaly

- extra-cardiac arteriovenous shunt

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12
Q

endocardial cushion defect (AV canal defect) –> assoc synd? (1)

A

Down synd

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13
Q

congenital heart dz:

  • increased pulm venous flow
  • increased arterial flow
  • decreased arterial flow

cyanotic vs acyanotic?

A
  • increased pulm venous flow: acyanotic
  • increased arterial flow: acyantoic
  • decreased arterial flow: cyantoic
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14
Q

congenital heart disease:

  • decreased pulm vasc
  • cardiomeg

what condition? (2)

A
  • Ebstein anomaly

- pulm atresia w intact septum

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15
Q

congenital heart disease:

  • decreased pulm vasc
  • normal heart size

what condition?

A

Tetralogy of Fallot

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16
Q

congenital heart disease:

  • increased pulm vasc
  • normal heart size

what condition? (5)

A

5 Ts:

  • transposition of great arteries
  • truncus arteriosus
  • tricuspid atresia
  • total anomalous pulm venous return (TAPVR)
  • single ventricle
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17
Q

hypoplastic L heart –> spectrum of anomalies –> which L heart struct can be involved? (5)

A
  • LA
  • LV
  • mitral valve
  • aortic valve
  • aorta
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18
Q

hypoplastic L heart –> fatal –> unless have what condition?

A

R-to-L shunt:

  • patent ductus arteriosus
  • ASD
  • patent foramen ovale
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19
Q

what is ductus arteriosus? natural progression after birth?

A

short connection bw proximal left pulmonary artery and aortic arch –> blood bypass the non-ventilated lungs in the fetus

after birth –> decrease prostaglandins & decrease pulm art pressure –> ductus close 2 days after birth –> blood into pulm vasculature –> ligamentum arteriosum

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20
Q

hypoplastic L heart –> tx?

A

Norwood procedure

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21
Q

what is Blalock-Taussig shunt?

A

graft –> connect R subclavian A –> R pulm A

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22
Q

what is bidirectional Glenn shunt?

A

SVC connect to R pulm A

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23
Q

what is modified Fontan?

A

tunneled conduit –> connect IVC –> pulm A

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24
Q

neonatal CHF –> 2 MCC?

A
  • vein of Galen malformation

- hepatic hemangioendothelioma

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25
ASD --> RtoL or LtoR shunt?
L-to-R
26
ASD --> when present?
later childhood - early adult
27
ASD --> assoc condition? (1)
Holt-Oram synd
28
Holt-Oram synd --> synd? (2)
- ASD | - UE bone deformity (ie absence/hypoplasia thumb)
29
ASD --> MC type? MOA?
ostium secundum septum secundum --> incompletely cover ostium secundum
30
ASD --> 2nd MC type? MOA?
ostium primum septum primum --> incompletely fuse to endocardial cushion
31
sinus venosus ASD --> assoc condition?
anomalous pulm venous drainage
32
ASD --> what structure(s) is enlarged?
RA --> RV --> pulm A
33
VSD --> when present?
1mo
34
VSD --> 2 types of location?
- #1 membranous | - muscular IV septum
35
VSD --> possible complication?
Eisenmenger synd
36
what is Eisenmenger synd?
pulm HTN --> reversal of shunt direction
37
VSD --> R or L heart is enlarged?
L
38
PDA --> classic clinical presentation?
premature --> 7-10 days of life --> CXR show CHF
39
endocardial cushion defect --> spectrum of anomalies --> such as? (4)
- ostium primum ASD - VSD - mitral anomaly - tricuspid anomaly
40
endocardial cushion defect --> assoc condition?
trisomy 21
41
what is Ebstein anomaly?
tricuspid valve --> severe malformation --> leaflets displaced apically --> obstruct pulm valve --> RV outflow tract obstruction --> atrialization of RV
42
Ebstein anomaly --> what concurrent condition 100%?
ASD
43
Ebstein anomaly --> CXR appearance?
- huge heart --> enlrg RA --> "box shape" | - decreased pulm vasc
44
CXR --> massive R atrial enlrg & decreased pulm vasc --> ddx? (2)
- Ebstein anomaly | - pulm atresia w intact ventricular septum
45
pulm atresia w intact ventricular septum --> what happens to... - RA - RV - pulm valve
- RA: enlrg - RV: hypoplasia - pulm valve: atretic
46
pulm atresia w intact ventricular septum --> how get pulm blood flow?
L-to-R shunt must be present (ie PDA)
47
Tetralogy of Fallot --> 4 components?
- pulm valve stenosis --> RV outflow tract obstruction - RV hypertrophy - VSD - aorta override VSD
48
what is pentalogy of Fallot?
tetralogy of fallot + ASD
49
pediatric --> MC cyanotic heart dz?
ToF
50
adult --> MC cyanotic heart dz?
ToF
51
Tetralogy of Fallot --> assoc synd? (3)
- DiGeorge synd - VACTERL - trisomy 21
52
DiGeorge synd --> synd? (3)
- ToF - absent thymus - absent parathyroid
53
Tetralogy of Fallot --> CXR appearance?
- normal size heart --> RV hypertrophy --> cardiac apex uplifted --> "boot shape" - decreased pulm vasc
54
Tetralogy of Fallot --> 25% have what other condition?
R aortic arch
55
Tetralogy of Fallot --> severe form?
pulm atresia w VSD
56
Tetralogy of Fallot --> tx?
surg: - close VSD - open RV outflow obstruct
57
newborn --> MC cyanotic heart dz?
transposition of great A
58
what is transposition of great A?
- RV --> aorta | - LV --> pulm A
59
transposition of great A --> what is required for survival?
site for blood mixture --> ie ASD, VSD, PDA, LtoR shunt)
60
transposition of great A --> US findings? (2)
- aorta ant to heart | - great vessels exit heart in parallel (rather than cross)
61
transposition of great A --> classic CXR finding? actual typical appearance?
classic: heart & narrow mediastinum --> "egg on a string" typical: - slightly narrow mediastinum - increased pulm vasc
62
transposition of great A --> why mediastinum narrow on CXR?
- parallel config of great vessels - thymus involute d/t stress - lack of main pulm bulge
63
transposition of great A --> tx?
Jatene procedure --> arterial switch
64
tricuspid atresia + small VSD --> CXR appearance?
- normal heart | - decreased pulm vasc
65
tricuspid atresia + lrgVSD --> CXR appearance?
- lrg heart | - increased pulm flow
66
MC congenital heart dz w right arch?
truncus arteriosus
67
what is truncus arteriosus?
single great art --> supplies: - systemic - pulm - coronary overrides a VSD
68
truncus arteriosus --> CXR appearance?
- cardiomeg - narrow mediastinum - pulm edema
69
what is total anomalous pulm venous return (TAPVR)?
pulm veins go to systemic venous circ instead of LA
70
TAPVR --> types? (4)
- supracardiac: L brachiocephalic V - cardiac: coronary sinus or RA - infracardiac: hepatic IVC/portal/hepatic V - mixed: combo of above
71
TAPVR --> MC type?
supracardiac
72
supracardiac TAPVR --> classic CXR finding?
snowman sign
73
TAPVR --> typical CXR appearance?
- normal heart | - pulm edema
74
TAPVR --> what must be present for blood to reach L heart?
interatrial R-L comm --> ASD
75
aortic coarctation --> locations? (3)
- preductal - periductal - postductal
76
aortic coarctation --> when present? - preductal - periductal - postductal
- preductal: infant - periductal: teen-early adult - postductal: teen-early adult
77
aortic coarctation --> assoc condition?
bicuspid aortic valve
78
aortic coarctation --> assoc synd?
Turner synd
79
aortic coarctation --> classic CXR finding in adult?
3 sign
80
tuberous sclerosis --> earliest sign in utero?
cardiac rhabdomyoma
81
MC cardiac tumor?
rhabdomyoma
82
pediatric cardiac tumors? (4)
- rhabdomyoma - teratoma - fibroma - hemangioma
83
2nd MC cardiac tumor detected in utero?
teratoma
84
cardiac teratoma --> MC location?
root of pulm A & aorta
85
pericardial teratoma --> potential complication?
massive perinatal pericardial effusion
86
cardiac fibroma --> MC location?
IV septum
87
cardiac hemangioma --> potential complication?
massive pericardial effusion
88
asplenia --> type of heterotaxy?
R-sided isomerism
89
polysplenia --> type of heterotaxy?
L-sided isomerism
90
Kawasaki dz --> acute phase --> what conditions are seen? (2)
- myocarditis | - heart fail
91
Kawasaki dz --> subacute phase --> what conditions are seen? (2)
coronary A aneurysm --> thrombus
92
hypoplastic L heart --> CXR findings?
- normal heart or cardiomeg | - pulm edema
93
transposition of great arteries --> D vs L?
D: - deoxy: RA --> RV --> aorta - oxy: LA --> LV --> pulm A L: (congenitally corrected) - deoxy: RA --> LV --> pulm A - oxy: LA --> RV --> aorta

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