Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/99

Click to flip

99 Cards in this Set

  • Front
  • Back
Life-threatening cardiac disease in newborn infants occur in about ___ in 1,000 live births.
3
Risk and Risk Factors

Maternal Diabetes ______________
HCM, VSD, TGA, COA
SLE could mean _________
congenital heart block
Congenital Rubella could mean _________-
PDA & PPS
___ risk in the general population
1%
____ risk for second pregnancy if first resulted in CHD
2-6%
______ for 3rd child if 1 & 2 = CHD
20-30%
Stenotic Lesions could be ________ or _______
Aortic stenosis
Pulmonary stenosis
Shunting Lesions could be ______ or _______
Right to Left
Left to Right
Mixing lesions could be ______,______, or_______
Truncus
TAPVR
HLHS
Acyanotic Congenital Heart lesions can be _________ or ________
volume lesions or obstructive lesions
Volume lesions involve left to right shunts or shunting of _________ blood back to the lungs. Increasing shunting leads to increased pulmonary blood flow, decreased pulmonary compliance, increase work of breathing and finally increase left ventricular output and failure.
fully oxygenated
Volume lesions include ______, ______,______, & ______
VSD, ASD, AV canal, and PDA
__________ hinder cardiac/pulmonary output leading to increased ventricular muscle mass (hypertrophy) to pump against the obstruction to maintain cardiac/pulmonary output
Obstructive lesions
Obstructive lesions include ________, __________, & _______
Valvular pulmonic stenosis, aortic stenosis, and coarctation of the aorta
______ is the most common cardiac anomaly with an incidence of 1.5 to 2.5 per 1,000 live births
VSD
VSD Seldom cause significant problems and are detected because of associated ________ usually not present at birth
heart murmur
4 types of VSD are
Perimembranous
Muscular
Subarterial defects
Malalignment defects
30-40% of VSD close spontaneously by age ____ months
6
______ has a murmur that is:
loud
harsh
blowing
pansystolic
LLSB +/- thrill
VSD
_____ of all Congenital Heart Disease is an Atrial Septal Defect
5-10%
______ has a murmur that is:
Ejection
Medium pitched
LMSB
2nd heart sound widely split
secondary to increase RV diastolic volume and prolonged ejection time
Atrial Septal Defect
Symptoms of ASD develop in the ____ decade of life
3rd
Late manifestations of ASD include:
________ Hypertension
Tricuspid and Mitral ________
______ arrhythmias
__________, paradoxical embolization through an ASD
Pulmonary

regurgitation

Atrial

Cerebrovascular accident
_____________ involves a normal part of fetal anatomy which allows 80-92% of right ventricular outflow to bypass the lungs and enter the descending aorta.
Patent Ductus Arteriosus PDA
PDA remains open in fetal life because of low ____.
PaO2
PDA usually closes in a term infant within __ day
1
Persistence of the PDA may lead to ______ and _________
pulmonary vascular disease
infective endocarditis
The __________ in PDA is a continuous musical/machinery like murmur heard best at the ULSB and subclavicular areas
Murmur
PDA also involves:
- ______ pulses
- Hyperdynamic precordium
- ______ EKG or mild LVH
- CXR
- _____ LA and LV
Bounding
Normal
Large
Coarctation of the Aorta (COA) is _____ of all CHD
8-10%
98% of COA occur _____the origin of the left subclavian artery
below
COA is _____ more likely in males
2X
30 % of those with ________ have COA
Turners Syndrome
those with COA often have ________ aortic valve in (70%)
Bicuspid
There is _______ BP proximal to COA & ________ BP distal to COA
Increased
Decreased
In COA, infants often present with signs and symptoms of _________ including:
-Weak peripheral pulses with poor perfusion
-Poor urine output
-Lethargy
-Poor feeding
-Metabolic acidosis
-No history of illness symptoms
cardiovascular collapse
What is this murmur?

S2 single and loud
No murmur in 50 %
Systolic ejection murmur
Gallop rhythm
Blood pressure differential upper vs lower extremity
Coarctation in Infant
What is this murmur?

Short systolic
LSB 3-4th space
Transmitted to back and neck
Interscapular murmur
Coarctation - Older Child
___% of patients w/ coarction have upper extremity hypertension
90
___% of patients w/ coarction have weak/absent femoral/pedal pulse
40
Some people with coarctation die between 20-40 yrs. of age secondary to ________
-Premature coronary artery disease
-Congestive heart failure
- Hypertensive encephalopathy
-Intracranial hemorrhage
Infective Endocarditis
hypertension
Cyanotic - 5 T’s and 1H
Tetralogy of Fallot
Transposition of the Great Arteries
Total Anomalous Pulmonary Venous Return
Tricuspid Atresia
Truncus Arteriosus
Hypoplastic Left Heart Syndrome
TOF occurs in _____% of CDH. Pulmonary Atresia in __%
10%
1%
Transposition of the Great Arteries occurs in _____ of those w/ CHD
5%
Total Anomalous Pulmonary Venous Return occurs in ____ of those w/ CHD
1%
Tricuspid Atresia occurs in _____% of those w/ CHD
1-3%
Truncus Arteriosus occurs in _____% of those w/ CHD
<1%
Hypoplastic Left Heart Syndrome occurs in _____% of those w/ CHD
1%
_______ is the most common cyanotic heart defect in children beyond infancy
Tetralogy of Fallot--TOF
Tetralogy of Fallot includes ____________, _________, _____________, ___________, _________
Pulmonary stenosis
Ventricular septal defect
Right ventricular hypertrophy
Overriding Aorta
25 % have a right sided aortic arch
With TOF _____ develops at birth or later depending on size of VSD (pink Tets)
Cyanosis
Your listening to a pts heart and you hear:
-S2 single in aortic component only
-A heart murmur with:
-Systolic ejection murmur
- long murmur
-Grade 3-5/6
-LUSB - LMSB
TOF
Occurring in am following crying, feeding, defecation, a pt w/ a CHD experiences:
-Severe hypoxia
-Hypernea
-Irritability/crying
** DECREASED HEART MURMUR**
TOF - Tet Spell
A severe spell can lead to:
-Limpness
-Seizure
-Cerebrovascular accident
-_________
Death
Tet Spell - Treatment
-Knee chest position
-Morphine
-Treat acidosis
-Vasoconstrictors (i.e., phenylephrine, Ketamine)
-Propranolol
note: ________ - doesn’t help
Oxygen
A 2 day old infant is noted to be feeding poorly with labored breathing. You note that the tongue appears blue tinged. Pulse Ox shows sats at 85 percent. 100% oxygen hood is given over 20 minutes. Blood gas reveals a PaO2 of only 78%.
CXR shows the “egg on a string” appearance of the cardiac silhouette
Transposition of the Great Arteries
Transposition of the Great Arteries is ____% of all Congenital Heart Disease
5%
In TOTGV the _____arises from the right ventricle and carries desaturated blood to the body.
The __________ arises from the left ventricle and carries saturated blood to the lungs.
aorta
pulmonary artery
Transposition of the Great Arteries ______ involve atrial or septal defects
may
Transposition of the Great Arteries involves Male: female ratio of _____
3:1
A child has cyanosis at birth
CHF with tachypnea, no respiratory distress.
S2 is single and loud with
amurmur (diagnosis does not depend on murmer, may or may not have murmur). There is a VSD. What is the likely diagnosis?
TGA-Transposition of the great arteries
A child with TGA that has a murmur has a _____________ as well.
Ventricular septal defect
TGA will show _______-hyperoxic challenge 100% FiO2 without increase of peripheral saturations or PaO2.
hypoxia
TGA will show Metabolic _______
acidosis
TGA CXR will show:
-________ with increased PVM
-Egg on a string = __________
cardiomegaly
narrow mediastinum
ECG will show ______ & _____
RAD, RVH/CVH
A newborn is noted to have profound cyanosis at birth. No murmur is heard EKG shows marked RVH. CXR demonstrates a large amount of interstitial fluid and pulmonary congestion. There is also an abnormal cardiac silhouette.
Total Anomalous Pulmonary Venous Connection
Total Anomalous Pulmonary Venous Connection is ___ of all Congenital Heart Disease
1%
Total Anomalous Pulmonary Venous Connection has a male: female ratio of _______.
Male > Female (4:1)
in _______________there is not a direct communication of the pulmonary veins to the left atrium
Total Anomalous Pulmonary Venous Connection
There are three types of Total Anomalous Pulmonary Venous Connection
1._____________
2._____________
3._____________
Supracardiac 50%
Intracardiac 20%
Infracardiac (subdiaphragmatic) 20% - present in first 3 days of life.
A baby is born that is cyanotic with congestive heart failure - tachypnea, dyspnea, hepatomegaly, tachycardia. S2 is widely split, increased P2. She has a gallop rhythm w/ no murmur. What is the likely diagnosis?
TAPVC
A 2 month old male infant presents for his well child check. He does not appear to be growing well (FTT). You note a large +4/6 SEM with a thrill that is harsh and located in the LLSB. You note mild cyanosis of the lips.
CXR shows a normal size heart with diminished pulmonary vascularity.
EKG show mark LVH
Tricuspid Atresia
Tricuspid Atresia is ____ of all Congenital Heart Disease
1-3%
In ___________ Tricuspid valve is absent. No outflow for venous blood from the heart. Blood shunted from a patent foramen ovale or large VSD. Hypoplastic right ventricle
Tricuspid Atresia
Severe cyanosis at birth or maybe normal depending on the size of VSD and PFO
Tachypnea and poor feeding.
Single S2
Murmur when VSD present
This presentation describes __________.
Tricuspid Atresia
A 3 week old infant is seen for turning blue with crying. Mom states no problems with the baby at delivery or in the newborn period. At the 2 week well visit a physiologic murmur is noted in the chart.
On examination the infant is tachypneic. A +2/6 SEM is noted at the ULSB and a +3/6 SEM is also noted in the LLSB.
CXR shows cardiomegaly and increased pulmonary vascularity and pulmonary venous congestion. EKG shows RVH
Truncus Arteriosus
Truncus Arteriosus is ____ of all Congenital Heart Disease
<1%
Truncus Arteriosus is associated with ________ and _____________
Associated with DiGeorge syndrome and absent thymus
In ___________ there is a single arterial trunk to the arterial and pulmonary system, almost always associated with a large VSD ventricular septal defect. There is a single valve bicuspid, tricuspid, quadracuspid.
Truncus Arteriosus
The four types of truncus arteriosus are differentiated by the position of the peripheral __________ on the arterial trunk.
pulmonary arteries
Those with TA may not have _______ at birth, depends on degree of PVR
cyanosis
Those with truncus Arteriosus develop ________
including:
-Tachypnea
-Poor feeding
-Failure to thrive
congestive heart failure
Those with TA have _______ pulses
Bounding
Those with TA have single S2 - with _______
click
Murmur for TA:
-Harsh systolic 2-4/6 LSB - VSD
-Diastolic decrescendo murmur at apex
-Truncal valve ________
regurgitation
A 2 day old female infant has been doing well in the newborn nursery. Suddenly she becomes lethargic and develops circulatory collapse.
Baby appears grayish and mottled. All peripheral pulses are absent. No murmur is heard.
CXR shows severe cardiomegaly, pulmonary congestion and increased pulmonary vascularity
Hypoplastic Left Heart Syndrome
Hypoplastic Left Heart Syndrome is ___ of Congenital Heart Disease
1%
Those with hypoplastic Left Heart Syndrome may do well initially until the ____ closes then shock, acidosis and hypotension with cardiac failure occurs
PDA
In those with Hypoplastic Left Heart Syndrome EKG reveals severe ____
RVH
HLHS involves mitral valve ______ vs atresia
stenosis
HLHS involves ________ left ventricle
Hypoplastic
HLHS involves Aortic valve ________ vs atresia
stenosis
HLHS involves, ______ ascending aorta and arch
Hypoplastic
Cardiac anomalies associated with HLHS are _______, _______, & ________.
Atrial septal defect
Ventricular septal defect
Coarctation of the aorta
Those with HLHS are Critically ill in the first few hours of life - dependent on timing of __________
ductal closure
The circulatory shock of HLHS results in ____ peripheral perfusion & ___
pulses
Poor
weak
HLHS results in severe cyanosis, Tachypnea, dyspnea
Single loud ___,No murmur, &
Gallop
S2