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Flashcards in Peds - Congenital Cardiovascular Deck (52):
1

Which valves are AV?

Between ATRIA and VENTRICLES
mitral
tricuspid

2

Which valves are semilunar?

aortic
pulmonic

3

What causes S1?

Closure of the AV valves

mitral
tricuspid

A is the 1st letter, AV make the S1 sound

4

What causes S2?

Closure of the semilunar valves

aortic pulmonic

5

When does systole occur?

Between S1 and S2

6

When does diastole occur?

Between S2 and S1

7

Generally speaking, what causes S3?

Increased fluid states

8

Generally speaking, what causes S4?

Stiff ventricular wall

9

What does S3 sound like?

Kentucky

10

What does S4 sound like?

Tennessee

11

Which valve is between the R atrium and the R ventricle?

Tricuspid

12

Which valve is between the L atrium and the L ventricle?

Mitral

13

Which valve is between the R ventricle and the pulmonary artery?

Pulmonic

14

Which valve is between the L ventricle and the aorta?

Aortic

15

Pneumonic for order of valves

To
Pay
More
Attention

16

Auscultation area - aortic
#

R upper sternal border

17

Auscultation area - pulmonic
#

L upper sternal border

18

Auscultation area - aortic or mitral

Apex (Erb's point)

19

Auscultation area - tricuspid or VSD

L lower sternal border

20

What might a thrill indicate?

VSD

ex: Tetralogy of Fallot

21

Congenital murmurs tend to be:

Systolic

22

Obstructive defects tend to have:

Ejection clicks due to turbulence
Referred or radiating sound

23

What is the most common congenital heart defect?

VSD

30%

24

Acyanotic lesions shunt which way?

Left to Right

25

Cyanotic lesions shunt which way?

Right to Left

26

acyanotic defect
systolic murmur @ Left UPPER sternal border
R ventricular hypertrophy

Atrial Septal Defect (ASD)

27

acyanotic defect
systolic murmur @ Left LOWER sternal border
may feel a holosystolic THRILL
L ventricular hypertrophy

Ventricular Septal Defect (VSD)

28

acyanotic defect
systolic murmur @ Left UPPER sternal border
HOLOSYSTOLIC
"machinery" sound
L ventricular hypertrophy

Patent Ductus Arteriosus (PDA)

29

cyanotic defect
(same murmur as VSD but with RVH)

systolic murmur @ Left LOWER sternal border
may feel a holosystolic THRILL

X-ray - "egg on a string"

Transposition of the Great Arteries

attempt to maintain PDA

30

cyanotic defect
loud systolic ejection click @ mid and UPPER L sternal border
THRILL #

X-ray - "boot shaped heart"

Tetralogy of Fallot

31

obstructive defect
systolic thrill @ R upper sternal border
ejection click which does NOT vary with respiration
L ventricular hypertrophy

Aortic Stenosis

32

obstructive defect
systolic murmur @ L upper sternal border
ejection click which DOES vary with respiration
R ventricular hypertrophy

Pulmonic Stenosis

33

obstructive defect

Coarctation of the Aorta

34

What can be given to stall closure of a PDA (as in the case of cyanotic defects)?

Prostaglandins

35

Four defects of Tetralogy of Fallot

- Large VSD
- pulmonary stenosis
- overriding aorta
- RVH

36

What is a "Tet spell" and with which disorder is it associated?

Hypercyanotic episode associated with Tetralogy of Fallot

often will squat or sleep in knee chest position to slow return of blood to the heart

periobital edema

37

What are the ACYANOTIC heart defects?
(3)

Atrial Septal Defect

Ventricular Septal Defect

Patent Ductus Arteriosus

38

What are the CYANOTIC heart defects?
(2)

Transposition of Great Arteries

Tetralogy of Fallot

39

What are the OBSTRUCTIVE heart defects?
(3)

Aortic Stenosis

Pulmonic Stenosis

Coarctation of Aorta

40

DiGeorge is associated with which cardiac defect?

aortic arch anomalies

41

Down's syndrome is associated with which cardiac defect?

septal defects

42

Edward's syndrome (Trisomy 18) is associated with which cardiac defect?

septal defects <

43

Marfan syndrome is associated with which cardiac defect?

aortic regurgitation
mitral valve prolapse

44

Turner's syndrome is associated with which cardiac defect?

coarctation of the aorta

45

Presenting signs and symptoms of child with cardiac defect?

cyanosis
exercise intolerance
diaphoresis
edema
clubbing

feeding problems
frequent respiratory infections

tachypnea during sleep
Beck's triad

46

Beck's Triad -
includes what?
indication of what?

o Lowered BP; widening of pulse pressure
o Distant heart sounds
o Jugular venous distention

Indicates cardiac defect

47

Pulse pressure definition

the difference between the systolic and diastolic BP readings

48

Characteristics of innocent murmur

No association with failure to thrive or cyanosis
low intensity (grade I-III)
may vary with position
no radiation

49

Why do innocent murmurs occur in up to 50% of children?

thin chest wall
more angulated great vessels
more dynamic circulation

50

Most common innocent murmur?
quality?
location?
cause?

Still's Murmur
musical
between L lower sternal border and APEX
caused by turbulence in LV outflow tract

(stiLL's murmur LL border)

51

Are innocent murmurs systolic or diastolic or both?

Only systolic

52

Venous Hum

INNOCENT
continuous hum
R upper sternal border
heard best in sitting position
disappears when supine or by turning head/compressing neck ipsilaterally