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84 Cards in this Set

  • Front
  • Back
Double outlet Right ventricle
Retinoic acid exposure
PA and AO come from RV. LV empties via VSD
DiGeorge, velocardiofacial, Catch 22
aortic arch abnormalities
Truncus arteriosus, TOF, PA w/ VSD
Ellis-van Creveld
ASD or single atrium
Fetal alcohol
VSD
Holt-Oram
ASD, VSD, arrhythmias
Marfan
Dilation of aorta, MVP w/ insufficiency
Noonan
Dysplastic pulmonic valve
ASD
Turner
coarct
bicuspid aortic valve
Williams
supravalvular aortic stenosis
pulmonary artery stenosis
trisomy 13
PDA, ASD, VSD, pulmonary and aortic atresia
trisomy 18
VSD, coronary abnormalities
trisomy 21
VSD, endocardial cushion defect, PDA, anomalous subclavian
Pompe
cardiomyopathy
glycogen in myocardium
MPS
MPS stuck in arteries, coronaries, and valves (stenosed or insufficient)
Hyperlipoproteinemia, fam type II
premature atherosclerosis
Friedreich ataxia
cardiomyopathy
muscular dystrophy
myocardial degeneration and fibrosis
Progeria
hypercholesterolemia, atherosclerosis
egg on string
TGA
increased vascular markings
most common cause of cyanotic heart in neonate
boot-shaped
TOF with pulmonic stenosis, apex turned upward
egg on side
TOF with pulmonary atresia
Signs of heart failure in infant
poor feeding, tachypnea, edemna, sweating, irritability
AV septal defect, signs, sx
RV hypertrophy. superior frontal plane qrs axis. systolic murmur. Downs S.
episodic acrocyanosis
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.
sx of hyperthyroidism
tremor, sinus tachy, weight loss, emotional lability.
Postural orthostatic tachycardia syndrome
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.
sx of large AVM
dilated cardiomyopathy at birth.Too much blood returns to heart, overt failure. CXR: increased vasculature. Sx of both L and R failure.
chest pain that is not benign.
constant, persistant pain,
episodic acrocyanosis
benign vasomotor change. must have sudden onset and sudden resolution. painless. common in newborn, less so in kids
Fe deficiency anemia in CHF is setup for
stroke
palpitations, sinus tach, fine tremor, weight loss
hyperthyroid. rare but fine tremor is key.
congenital dilated cardiomyopathy with diminished pulses, etiology
AVM of liver or brain
pheochromocytoma CV finding
severe, paroxysmal hypertension
hyperthyroidism neonatal, CV etiology
high-output failure with brisk pulses
carnitine deficiency, CV findings
progressive cardiomyopathy onset 2-4yrs. with or without skeletal muscle weakness. Carnitine transports fatty acids into mitochondira for breakdown.
signs of pericarditis
constant chest pain for several days, worsened supine.
when to work-up HTN
systolic or diastolic > 95% regardless of FH
gradual onset of CHF in 4mo old
unobstructed total anomalous pulmonary venous return. supracardiac type: returns to confluence behind L atrium and flows to innominate and SVC, must have ASD.
sx of pulmonary AVM
shunting L heart blood to R bypassing lungs: cyanosis
truncus arteriosus commnunis sx
truncus overrides large VSD. CHF defelops over first month
hypoplastic L heart, sx
profound CHF, shock, death early. can be delayed but not past one month, due to PDA
TGA, sx
cyanosis within hrs.
hypoplastic L heart PE
S2 loud, single, and palpable. no murmur, weak pulses
age at which PDA normally closes in well preterm infants
4 days
largest risk factor for stroke in patient with any congenital heart problem
Fe deficiency anemia, which may be masked by "normal" Hb count (should be elevated in cyanotic CHD)
acquired conduction problem in previously healthy child
likely myocarditis (viral or autoimmune) which happens to affect the conduction pathways.
preductal anatomy, postductal anatomy
preductal: R arm
postductoal: L arm, both legs
Sats lower in preductal than postductal
TGA
CXR in TGA
normal
hyperoxia challenge test. pulse ox vs PaO2
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.
truncus arteriosus presentation
first weeks with CHF and murmur due to hi pulmonary bood flow. cyanosis and hypoxia are mild. CXR: increased vasc.
syncope and pulseless arrest in exercise which revives. Nl EKG
abnormal coronoaries. do cath and stress test.
most common cause of sudden death in teen athlete
hypertrophic cardiomyopathy., would show up on EKG and echo
cardiac causes of wheezing
L heart obstruction, like coarct, aortic stenosis
Jones criteria
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.
type of arthritis in RF
most common sx of acute rheumatic fever. large joints, knees, ankles, elbows, wrists. usually more than one simultaneously or sequentially
murmur of acute rheumatic fever
MR or AR almost always present if carditis is present. (50% of patients)
erythema marginatum, description
<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.
subcutaneous nodules, description
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.
JRA vs rheumatic fever arthritis
JRA often involves peripheral small joints and symmetrical large joints, no migratory. no strep, ASA does not "cure" within 48hrs.
ASD types
seccundum is most common (middle), fossa ovalis failure
primum is closes to TV and is involved in endocardial cusion defect.
ASD murmur
systolic ejection LUSB (relative PS), FIXED SPLIT S2. LLSB diastolic rumble from relative TS. The L -R shunt is silent (too low pressure)
ASD spontaneous closure rates
<3mm by 3mo all close by 1.5yr
3-8mm by 3mo 80% close
>8mm don't close
ASD EKG and CXR
RBBB, rsR' in V1, RVH, increased vascular markings. RV enlargement, normal L heart.
postpericardiotomy syndrome
pericarditis, pericardial tamponade. occurs days-weeks after surgery. abdominal fullness, vomiting, pulsus paradoxus.
pulsus paradoxus
accentuation of normal decrease in stroke volume from LV with inspiration. classic sign of pericardial tamponade.
superior vena cava syndrome
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.
most common finding with chronic endocarditis
splenomegaly. osler nods and Janeway lesionsa re very rare in kids.
murmur of MVP
late systolic honk with midsystolic click moves earlier with stand. moves later with squat
description of Downs
low nasal bridge, flat occiput, clindoactyly of 5th dig, wide space between 1-2 toes, hypotonia
Age at which CHF developes with large VSD
2 months, after pulm vasc resistance falls.
treatment for mycoardial dysfxn from chemo (doxoru)
diuretics and ACE inhib
CHD that does not need Abx prophylaxis
ASD secc, repaired VSD or ASD, ligated PDA.
proof of endocarditis in MVP teen
Strep viridans + culture
most common bacterial cause of pericarditis
was Hib, now very rare. S. aureus.
Turner syndrome heart finding
aorta problems. coarct, bicuspid aortic valve with stenosis/.
Coarct murmur
continuous murmur, mheard over L scapula.
genetics of hypertrophic cardiomyopathy
AD but lots of spontaneous mutations, many loci. variable expression.
presentation of hypoplastic L heart
tachpnea and mild or no cyanosis single second hear sound. increased precordial activity.
pulmonary atresia with intact ventricular septum, presentation
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
most likely complication of erythrocytosis in CHD
stroke
PaO2 of mixing lesions on superoxy test
40-150torr. as compared to TGA or pulm atresia which has 30-50
myocarditis vs pericarditis
both have abdominal pain and vomitin. pericarditis with tampanod has pulsus paradoxus. myocarditis has pulsus alternans (2:1 conduction)
bicuspid aorta murmur
mid systolic click. unlike MVP does not vary with squatting vs standing.