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20 Cards in this Set
- Front
- Back
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1. Eisenmenger syndrome?
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a. Pulmonary THN resulting in right-to-left shunting of blood.
b. This may occur with: 1. large ventricular septal defects (VSDs) 2. Atrioventricular canal lesions 3. PDA |
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2. Left-To-Right shunt?
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a. Flow of blood from the systemic circulation into the pulmonary circulation across na anomalous connection, such as a PDA.
b. Such lesions result in pulmonary congestion and systemic hypoperfusion, but they typically do not cause cyanosis. |
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3. Widened Pulse Pressure
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a. An increase in the difference between systolic and diastolic pressures, resulting in a bounding arterial pulse.
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4. Conditions that cause a widened pulse pressure?
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a. Fever
b. Hyperthyroidism c. Anaemia d. AV fistulas e. PDA |
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5. How are congenital cardiac defects first categorized?
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a. To the presence of cyanosis.
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6. Next step in characterizing congenital cardiac defects?
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a. According to chest radiographic findings of increased, normal, or decreased pulmonary vascular markings, and then finally according to ventricular forces indicated on ECG.
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7. What do the majority of acyanotic lesions result in?
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a. A change in volume load, usually from the systemic circulation to the pulmonary circulation (so-called left-to-right shunt).
b. If left untreated, defects that affect volume load can eventually result in increased pulmonary vascular pressure, causing a reversal of blood flow across the defect and clinical cyanosis. |
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8. Most common heart lesion in children?
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a. VSD
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9. Small VSD presentation?
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a. Children w/small VSDs are usually asymptomatic
b. Harsh, left lower sternal border holosystolic murmur. |
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10. Large VSD presentation?
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a. Murmur of a large VSD may be less harsh! Bc of the absence of a significant pressure gradient across the defect.
b. Large lesions are accompanied by: 1. Dyspnea 2. Feeding difficulties 3. Growth Failure. 4. Perfuse perspiration 5. May lead to recurrent infections and Cardiac Failure. |
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11. Are infants w/Large VSDs cyanotic?
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a. Generally NO!
b. May become dusky during feeding or crying. c. With significant VSDs, chest radiograph shows cardiomegaly and pulmonary vascular congestion. d. ECG shows biventricular hypertrophy. |
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a. Generally NO!
b. May become dusky during feeding or crying. c. With significant VSDs, chest radiograph shows cardiomegaly and pulmonary vascular congestion. d. ECG shows biventricular hypertrophy. |
a. Close spontaneously by 6-12 months.
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13. Medical management of VSD? (Reserved for children who are symptomatic from large VSDs)
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a. Diuretics (Furosemide, Chlorothiazide)
b. Afterload reduction (Ace inhibitors) c. Sometimes digoxin. |
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14. Note: when monitoring children w/large VSDs, one should not be misled by a softening murmur, as this may herald pulmonary vascular disease or infundibular stenosis rather than closure of the defect.
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14. Note: when monitoring children w/large VSDs, one should not be misled by a softening murmur, as this may herald pulmonary vascular disease or infundibular stenosis rather than closure of the defect.
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15. When do most children w/large VSDs develop pulmonary vascular resistance?
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a. After 1 yr of age although it can occur early.
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16. What children are at particular risk for VSD?
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a. Trisomy 21.
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17. When are VSDs treated surgically?
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a. In children w/persistently large shunts after 1 yr.
b. 1/3 of these children have irreversible pulmonary vascular disease by 2 yrs of age (Eisenmenger syndrome). |
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18. In whom is PDA most commonly seen?
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a. Preterm infants.
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19. When does Ductus closure in term infants normally occur?
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a. Within 10-15 hours of birth and almost always by 2 days.
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20. S/S of PDA?
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a. A large PDA typically has:
1. A systolic or continuous “machinery-like” murmur. 2. Active precordium 3. Widened pulse pressure. b. Small PDA typically has no sx. |
