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84 Cards in this Set
- Front
- Back
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Double outlet Right ventricle
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Retinoic acid exposure
PA and AO come from RV. LV empties via VSD |
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DiGeorge, velocardiofacial, Catch 22
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aortic arch abnormalities
Truncus arteriosus, TOF, PA w/ VSD |
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Ellis-van Creveld
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ASD or single atrium
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Fetal alcohol
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VSD
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Holt-Oram
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ASD, VSD, arrhythmias
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Marfan
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Dilation of aorta, MVP w/ insufficiency
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Noonan
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Dysplastic pulmonic valve
ASD |
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Turner
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coarct
bicuspid aortic valve |
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Williams
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supravalvular aortic stenosis
pulmonary artery stenosis |
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trisomy 13
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PDA, ASD, VSD, pulmonary and aortic atresia
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trisomy 18
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VSD, coronary abnormalities
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trisomy 21
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VSD, endocardial cushion defect, PDA, anomalous subclavian
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Pompe
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cardiomyopathy
glycogen in myocardium |
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MPS
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MPS stuck in arteries, coronaries, and valves (stenosed or insufficient)
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Hyperlipoproteinemia, fam type II
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premature atherosclerosis
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Friedreich ataxia
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cardiomyopathy
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muscular dystrophy
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myocardial degeneration and fibrosis
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Progeria
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hypercholesterolemia, atherosclerosis
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egg on string
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TGA
increased vascular markings most common cause of cyanotic heart in neonate |
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boot-shaped
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TOF with pulmonic stenosis, apex turned upward
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egg on side
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TOF with pulmonary atresia
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Signs of heart failure in infant
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poor feeding, tachypnea, edemna, sweating, irritability
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AV septal defect, signs, sx
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RV hypertrophy. superior frontal plane qrs axis. systolic murmur. Downs S.
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episodic acrocyanosis
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hands and feet turning intensely blue. inbetween spells may be mottled. benign. suddent onset and resolution of cyanosis. common in infants, rare in toddlers, more rare after. Must have glove or stocking distribution.
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sx of hyperthyroidism
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tremor, sinus tachy, weight loss, emotional lability.
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Postural orthostatic tachycardia syndrome
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episodic sinus tach and chest discomfort with intolerance to upright posture. ortho BP is normal. tilt table test reproduces sx. Usually do not faint, but have FH of fainters.
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sx of large AVM
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dilated cardiomyopathy at birth.Too much blood returns to heart, overt failure. CXR: increased vasculature. Sx of both L and R failure.
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chest pain that is not benign.
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constant, persistant pain,
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episodic acrocyanosis
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benign vasomotor change. must have sudden onset and sudden resolution. painless. common in newborn, less so in kids
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Fe deficiency anemia in CHF is setup for
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stroke
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palpitations, sinus tach, fine tremor, weight loss
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hyperthyroid. rare but fine tremor is key.
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congenital dilated cardiomyopathy with diminished pulses, etiology
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AVM of liver or brain
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pheochromocytoma CV finding
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severe, paroxysmal hypertension
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hyperthyroidism neonatal, CV etiology
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high-output failure with brisk pulses
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carnitine deficiency, CV findings
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progressive cardiomyopathy onset 2-4yrs. with or without skeletal muscle weakness. Carnitine transports fatty acids into mitochondira for breakdown.
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signs of pericarditis
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constant chest pain for several days, worsened supine.
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when to work-up HTN
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systolic or diastolic > 95% regardless of FH
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gradual onset of CHF in 4mo old
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unobstructed total anomalous pulmonary venous return. supracardiac type: returns to confluence behind L atrium and flows to innominate and SVC, must have ASD.
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sx of pulmonary AVM
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shunting L heart blood to R bypassing lungs: cyanosis
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truncus arteriosus commnunis sx
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truncus overrides large VSD. CHF defelops over first month
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hypoplastic L heart, sx
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profound CHF, shock, death early. can be delayed but not past one month, due to PDA
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TGA, sx
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cyanosis within hrs.
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hypoplastic L heart PE
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S2 loud, single, and palpable. no murmur, weak pulses
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age at which PDA normally closes in well preterm infants
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4 days
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largest risk factor for stroke in patient with any congenital heart problem
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Fe deficiency anemia, which may be masked by "normal" Hb count (should be elevated in cyanotic CHD)
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acquired conduction problem in previously healthy child
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likely myocarditis (viral or autoimmune) which happens to affect the conduction pathways.
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preductal anatomy, postductal anatomy
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preductal: R arm
postductoal: L arm, both legs |
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Sats lower in preductal than postductal
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TGA
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CXR in TGA
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normal
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hyperoxia challenge test. pulse ox vs PaO2
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pulse ox is not important. may reach 100% with FiO2 100 but if PaO2 does not rise significantly above 100torr, the test is still abnormal.
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truncus arteriosus presentation
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first weeks with CHF and murmur due to hi pulmonary bood flow. cyanosis and hypoxia are mild. CXR: increased vasc.
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syncope and pulseless arrest in exercise which revives. Nl EKG
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abnormal coronoaries. do cath and stress test.
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most common cause of sudden death in teen athlete
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hypertrophic cardiomyopathy., would show up on EKG and echo
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cardiac causes of wheezing
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L heart obstruction, like coarct, aortic stenosis
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Jones criteria
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J: migratory polyarthritis
O: myocarditis with MR N: subcutaneous nodules E: erythema marginatum S: chorea 2 major or 1 major 2 minor minor: fever, lab findings of inflammation, arthralgia, hx of ARF, PR prolonged. |
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type of arthritis in RF
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most common sx of acute rheumatic fever. large joints, knees, ankles, elbows, wrists. usually more than one simultaneously or sequentially
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murmur of acute rheumatic fever
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MR or AR almost always present if carditis is present. (50% of patients)
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erythema marginatum, description
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<10% of patients with acute rheumatic fever. nonpruritic, serpiginous or annuolar pink rash. trunk, inner proximal extrem. never on face. dissappears with cold, accentuated with heat. evanescent.
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subcutaneous nodules, description
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2-10% patients with rheumatic fever. hard, painless, freely movable nodules 2mm-2cm over extensor surface of joints., scalp, spine, elbow. not transient (lasts for weeks) associated with carditis.
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JRA vs rheumatic fever arthritis
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JRA often involves peripheral small joints and symmetrical large joints, no migratory. no strep, ASA does not "cure" within 48hrs.
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ASD types
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seccundum is most common (middle), fossa ovalis failure
primum is closes to TV and is involved in endocardial cusion defect. |
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ASD murmur
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systolic ejection LUSB (relative PS), FIXED SPLIT S2. LLSB diastolic rumble from relative TS. The L -R shunt is silent (too low pressure)
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ASD spontaneous closure rates
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<3mm by 3mo all close by 1.5yr
3-8mm by 3mo 80% close >8mm don't close |
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ASD EKG and CXR
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RBBB, rsR' in V1, RVH, increased vascular markings. RV enlargement, normal L heart.
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postpericardiotomy syndrome
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pericarditis, pericardial tamponade. occurs days-weeks after surgery. abdominal fullness, vomiting, pulsus paradoxus.
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pulsus paradoxus
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accentuation of normal decrease in stroke volume from LV with inspiration. classic sign of pericardial tamponade.
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superior vena cava syndrome
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hx of ECMO. progressive thrombosis of SVC. facial edema, laryngeal edema with cough or croup sound. progressive hydrocephalus. MRI of chest is best test to determine if SVC is occluded.
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most common finding with chronic endocarditis
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splenomegaly. osler nods and Janeway lesionsa re very rare in kids.
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murmur of MVP
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late systolic honk with midsystolic click moves earlier with stand. moves later with squat
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description of Downs
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low nasal bridge, flat occiput, clindoactyly of 5th dig, wide space between 1-2 toes, hypotonia
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Age at which CHF developes with large VSD
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2 months, after pulm vasc resistance falls.
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treatment for mycoardial dysfxn from chemo (doxoru)
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diuretics and ACE inhib
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CHD that does not need Abx prophylaxis
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ASD secc, repaired VSD or ASD, ligated PDA.
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proof of endocarditis in MVP teen
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Strep viridans + culture
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most common bacterial cause of pericarditis
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was Hib, now very rare. S. aureus.
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Turner syndrome heart finding
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aorta problems. coarct, bicuspid aortic valve with stenosis/.
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Coarct murmur
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continuous murmur, mheard over L scapula.
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genetics of hypertrophic cardiomyopathy
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AD but lots of spontaneous mutations, many loci. variable expression.
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presentation of hypoplastic L heart
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tachpnea and mild or no cyanosis single second hear sound. increased precordial activity.
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pulmonary atresia with intact ventricular septum, presentation
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single second heart sound. initially PDA supplies all pulmonary art blood and hi pulm resistance means little gradient across PDA, so little murmur. Very hypoxic, cyanotic
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most likely complication of erythrocytosis in CHD
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stroke
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PaO2 of mixing lesions on superoxy test
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40-150torr. as compared to TGA or pulm atresia which has 30-50
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myocarditis vs pericarditis
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both have abdominal pain and vomitin. pericarditis with tampanod has pulsus paradoxus. myocarditis has pulsus alternans (2:1 conduction)
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bicuspid aorta murmur
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mid systolic click. unlike MVP does not vary with squatting vs standing.
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