Pediatrics Cardio

eesohbel's version from 2015-12-05 19:30

Where Do You Hear Me

Question Answer
Aortic stenosisupper right sternal border
flow murmurupper right sternal border
aortic valve sclerosisright upper sternal boarder
pulmonic stenosisupper left sternal border
flow murmur (ASD)upper left sternal border
tricuspid regurglower left sternal border
tricuspid stenosislower left sternal border
apexmitral regurg
apexmitral stenosis
PDAleft intraclavicular area (upper left sternal border)
VSDlower left sternal border

General Heart Murmurs

Question Answer
crescendo-decrescendo systolic ejection murmuraortic stenosis
holosystolic, blowing murmurmitral/tricuspid regurgitation
midsystolic click with late systolic crescendo murmurMVP
holosystolic, harsh sounding murmurVSD
high pitched blowing early diastolic decrescendo murmurAR
follows opening snap with delayed rumbling late diastolic murmurMS
continuous machine like murmurPDA
innocent murmurnever diastolic,
wide fixed splitting of S2ASD and endocardial cushion defect

Pediatric Heart Conditions and their disease associations

Question Answer
ASD and endocardial cushion defectsDown syndrome
PDAcongenital rubella
coarctation of the aortaTurner
coronary artery aneyursmsKawasaki
congenital heart blockneonatal lupus
supravalvular aortic stenosiswilliams
ebsteinsmaternal lithium use during pregnancy
transposition of the great vesselsmaternal diabetes
bicuspid aortic valveTurners

Cyanotic heart disease in newborns

Question Answer
single S2 and VSD murmurtransposition of the great vessels
egg on a string x raytransposition
treatment of TGAstart IV PGE to maintain the PDA and balloon atrial septostomy to create an ASD
boot shaped heartTOF
harsh pulmonic stenosis murmur/VSD/crescendo decrecendo systoluc murmur over L upper sternal borderTOF
single S2 and VSDtricsupid atresia
to be compatible w life need ---- in TGAseptal defect and a PDA
single S2 and systolic ejection murmurtruncus arteriosus
total anomalous pulmonary venous returnsevere cyanosis and respiratory distress
snowman sign (enlarged supracardiac veins and SVC)total anomalous pulmonary venous return with obstruction
why will child squat in TOFincrease SVR and decrease right to left shunt
severe cyanosis in newborn, decreased pulmonary blood, left axis deviation and LVHtricuspid atresia
pulmonary blood flow depends on prescence and size of VSDtricuspid atresia
holosystolic murmor of tricuspid insuffiencyebstein anomaly
egg on the string appearanceTGA
single S2TGA
snowman appearance on X-rayTAPVR
enlarged right atrium, right ventricle and pulmonary artery, and small left atriumTAPVR
central cyanosis and HF in first few weeks of life, no murmurshypoplastic left heart syndrome
CXR findings in coarctation of the aorta3 sign and ribnotching

acyanotic heart disease

Question Answer
when to repair VSDsymptomatic patients who fail medical management, children less than ` year of age with signs of pulmonary hypertension, and older children with large VSDS
fixed, widely spilt S2ASD
bounding peripheral pulsesPDA

Other Cardiac Pathology

Question Answer
staph endocarditismore common in those without underlying heart disease
strep endocaridtismore common in patients with underlying heart disease or after dental procedures
clinical presentation of IEprolonged fever; new or changing heart murmur
ARFrelated to GAS infection within several weeks
prescence of Sydenham's choreasufficient for diagnosis of ARF
if chorea isolated in ARF treat withphenobarbital
low voltage QRSpericarditis
pulsus paradoxusa drop in BP greater than 20mnHg during inspiration in a child w pericarditis indicates cardiac tamponade
when a child presents with hypertension thinkrenal causes

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