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28 Cards in this Set
- Front
- Back
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1. When does Cyanotic CHD often manifest itself?
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a. After the PDA begins to close (i.e., ductus dependent)
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2. What keeps the ductus open?
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a. Prostaglandin E, an IV med.
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3. What is Cyanotic CHD characterized by?
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a. Decreased pulmonary blood flow.
b. Unsaturated blood returning to the heart from the periphery is shunted into the systemic circulation, thus bypassing the lungs. |
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4. Transposition of the Great Arteries (TGA) appearance on radiograph?
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a. Egg-on-a string
b. Although the appearance may be normal in the first few days of life. |
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5. TGA on ECG?
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a. Shows the normal right-sided dominant pattern of the neonate.
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6. Confirmation of TGA diagnosis?
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a. Echo.
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7. Initial management of TGA (after prostaglandin E)?
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a. Creation of an atrial septum (“atrial septostomy”) via cardiac cath, which provides immediate symptom palliation.
b. Definition surgical care often occurs in the first 2 weeks of life. |
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8. Complication of TGA repair?
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a. Repair site stenosis is a potential long-term complication.
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9. Pulmonary Valve Stenosis?
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a. A cyanotic CHD (accounts for 20-30% of CHD)?
b. Cyanosis and exercise intolerance, if any, are proportional to the degree of stenosis. |
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10. How does Pulmonary Valve Stenosis appear on auscultation?
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a. Upper left sternal border systolic murmur that radiates to the back
b. And c. A systolic click. |
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11. ECG for Pulmonary Valve Stenosis?
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a. Normal in mild cases.
b. Greater stenosis causes right-axis deviation and right ventricular hypertrophy. |
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12. Tx of Pulmonary Valve Stenosis?
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a. Valvuloplasty is achieved via cardiac cath
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13. In what genetic conditions may Pulmonary stenosis occur?
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1. Glycogen storage disease
2. Noonan syndrome |
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14. Characteristic radiographic finding w/TET?
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a. Boot or wooden shoe appearance
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15. Pink Tetralogy?
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a. Occurs if pulmonary stenosis is mild at birth, neonates have normal colour “pink tet”.
b. By early childhood most become cyanotic as a result of stenotic progression. |
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16. Tetralogy spells?
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a. Many children w/TOF also experience hypercyanotic spells “tetralogy spells”
b. Caused by sudden increase in right-to-left shunting of blood. c. May be brought on by activity or agitation, or they may occur w/o apparent precipitant. d. Such children can be seen assuming a squatting posture, which compresses peripheral blood vessels, thus increasing pulmonary blood flow and systemic arterial oxygen saturation. |
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17. Prognosis of Tet?
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a. With current surgical management, 90% of pts w/TOF survive to adulthood.
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18. Hallmark of children who have tricuspid valve abnormalities of tricuspid atresia or Ebstein Anomaly?
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a. Cyanosis!
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19. Pathophys of Tricuspid atresia?
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a. No outlet exists between the right atrium and right ventricle, forcing systemic enous return to enter the left atrium via the foramen ovale or an associated ASD.
b. A VSD is also often present. |
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20. Pathophys of Tricuspid valve of Ebstein anomaly?
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a. Usually is regurgitant and often obstructs ventricular outflow bc or a large anterior leaflet.
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21. Note: Both Tricuspid atresia and Tricuspid valve of Ebstein anomaly are “ductal dependent” in the neonate, and both require surgical correction.
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21. Note: Both Tricuspid atresia and Tricuspid valve of Ebstein anomaly are “ductal dependent” in the neonate, and both require surgical correction.
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22. How can you differentiate a benign pulmonary flow murmur from a pathological pulmonary murmur?
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a. The benign murmur does not radiate.
b. No click is heard c. No s/s of cardiac disease (digital clubbing, cyanosis, exercise intolerance) are found. |
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23. 3 Benign childhood murmurs?
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a. Peripheral pulmonic stenosis
b. Venous hum (A low-pitched murmur at the sternal notch only when the child is upright) c. Still vibratory murmur (A high-pitched “musical” systolic murmur heard best at the left sternal border in the supine position). |
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24. Venous hum in child?
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a. A low-pitched murmur at the sternal notch only when the child is upright
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25. Still vibratory murmur?
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a. A high-pitched “musical” systolic murmur heard best at the left sternal border in the supine position.
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26. Note, although pulmonary stenosis and tricuspid atresia are cyanotic heart lesions, exercise-induced cyanosis and systolic murmur are characteristic if pulmonary stenosis.
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26. Note, although pulmonary stenosis and tricuspid atresia are cyanotic heart lesions, exercise-induced cyanosis and systolic murmur are characteristic if pulmonary stenosis.
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27. 4 Heart Defects in Tet?
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1. Overriding aorta
2. Pulmonic Stenosis 3. VSD 4. Right ventricular hypertrophy. |
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28. Best initial management of cyanotic heart disease?
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a. Administer Prostaglandin E1!
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