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31 Cards in this Set
- Front
- Back
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what is the difference btw acrocyanosis and central cyanosis?
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acro: normal, no lowered saturation of arterial blood
central: lips, tongue, skin blue; Desaturation of arterial blood |
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if you have a right to left shunt what will you see
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cyanosis
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if a pt is breathing fast, and has no abnormal breath sounds what do you think might be causing the problem?
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CARDIAC ISSUE
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if a baby is having weak sucks, convulsions, shallow irregular respirations and poor muscle tone what are you thinking is the etiologic cause?
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CNS
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what does the hyperoxia challenge help determine?
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A way to distinguish whether cyanosis is from cardiac disease or from pulmonary disease
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how does a hyperoxia test show CHD?
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Infants with cyanotic CHD do not show significant increase in PaO2 after 100% oxygen given
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how does a hyperoxia test show pulmonary disease?
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Neonates with pulmonary disease show significant increase in PaO2 with administration of 100% oxygen (except when severe lung disease present)
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when given a hyperoxia test Failure to rise to above 150mmHg suggests cyanotic ______
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congenital heart abnormality
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what are the 5 Ts?
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Tetralogy of Fallot
Tricuspid Atresia Transposition of the Great Arteries (TGA) Truncus Arteriosus Total Anomalous Pulmonary Venous Return (TAPVR) |
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what is involved in the tetrology of Fallot??
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overriding aorta
VSD pulmonary stenosis RVH |
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what happens in Truncus Arteriosus
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aorta and PA are not separated
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when you get a chest xray, and you see egg on a string apparence, what do you have?
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Transposition of the Great Arteries (TGA)
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if you get a chest xray and have a boot shaped heart what do you have
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tetralogy of fallot
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when you get a chest xray and have a snowman appearance what do you have?
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Total Anomalous Pulmonary Venous Return (TAPVR)
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describe Total Anomalous Pulmonary Venous Return (TAPVR)
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none of the four veins that take blood from the lungs to the heart is attached to the left atrium
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what does the ductus arteriosus do?
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connects main pulmonary trunk to descending aorta
In fetus, shunts blood away from lungs |
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what is a ductal dependant lesion?
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A cardiac lesion requiring a patent ductus arteriosus (PDA) to maintain life
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what are the 2 types of ductal dependent lesions?
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Lesions depending on the PDA for adequate:
Pulmonary blood flow or Systemic blood flow |
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Can we do anything to keep a PDA open after birth?
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Yes! Prostaglandin E1
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Alprostadil =?
what does this do? |
Prostaglandin E1
keeps PDA open |
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if a baby has a continuous machinery-like murmur, what does he have?
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PDA
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How can we close a PDA if the baby is not dependent on it?
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NSAIDs
Surgery or transcatheter approach |
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when do you normally need a PDA to survive?
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when you have a R to L shunt
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what is Indomethacin used for?
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closure of a PDA
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what is Eisenmenger Syndrome?
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Blood is shunted R to L due to pulmonary vascular disease
note: it was originally a L to R, but an increased HT drives it to be R to L) |
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what is a Tet spell? when does it happen?
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seen with tetrology of fallot
get worsening cyanosis, possible syncope, restlessness, etc. this occurs in the morning or after crying |
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how can you relieve a tet spell? what about treatment?
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Sometimes relieved by placing the infant on the abdomen in knee-chest position which “traps” venous blood in legs to decrease venous return and calm child
Treatment is oxygen and morphine |
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patient has a cocktail personality and is said to have Williams Syndrome. What are the cardiac problems seen?
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aoritc stenosis and renal artery stenosis
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What are the 2 major cardiac problems seen in Turner syndrome?
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Coarctation of the aorta
Bicuspid aortic valves |
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Describe the problems seen in DiGeorge Syndrome
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Remember CATCH-22
Cardiac anomalies (TOF most common, also VSD, interrupted aortic arch, persistent truncus arteriosus) Abnormal facies (hypertelorism, micrognathia, short philtrum, “fish mouth” appearance, low set ears) Thymic aplasia/hypoplasia Cleft palate Hypocalcemia REMEMBER: it is a 22q11 chromosome deletion syndrome |
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what is the problem to worry about in marfan?
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Aortic root dilation
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