6613381
Descripción
Fichas por Liam Musselbrook, actualizado hace más de 1 año
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Creado por Liam Musselbrook
hace alrededor de 8 años
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| Pregunta | Respuesta |
| Nine most common abnormalities (accounting for 80% of all lesions) | |
| Describe the changes at birth to the baby's circulation | Closure of umbilical vessels Increased systemic vascular resistance Decreased pulmonary vascular resistance Increased pulmonary blood flow Closure of ductus arteriosus, foramen ovale and ductus venosus |
| Teratogens and their effects | Rubella Coarct, VSD, PDA Alcohol VSD Phenytoin ASD Lithium Ebsteins anomaly Warfarin VSD, TOF |
| ACYANOTIC CHD | VSD PDA ASD Coarctation of the aorta Aortic stenosis |
| CYANOTIC CHD | Transposition of the Great Arteries Tetralogy of Fallot Pulmonary Atresia Ebstein Anomaly Tricuspid Atresia |
| What are the signs and symptoms of HF in children? | FTT, Sweating, Poor feeding, Lethargy, TACHYCARDIA WITHOUT RECESSION, Hepatomegaly, Pallor/Cyanosis, Murmer |
| The Three 3s of CHD | 3 Holes 3 Blocked Pipes 3 Blue Babies |
| 3 Holes | Ventricular Septal Defect (VSD) Atrial Septal Defect (ASD) Patent Ductus Arteriosus |
| Ventral Septal Defect (VSD) Presentation | Commonest CHD - >30% Asymptomatic Recurrent chest infections Heart Failure |
| Clinical features of VSD | Pansystolic murmur (LLSE) Thrill LSE |
| Management of VSD | Conservative - feeds, diuretics, ACEi Surgery - 3-6 months |
| Atrial Septal Defect (ASD) Presentation | Asymptomatic Recurrent chest infections Dyspnoea |
| ASD Clinical features | FIXED SPLITTING of 2nd heart sound Ejection systolic murmur (Upper Left Sternal Edge) |
| Management of ASD | Most close spontaneously 3-5 yrs: cardiac catheterisation or surgery |
| Patent Ductus Arteriosus | 12% Commonest in preterm Continuous murmur Collapsing pulse Sick neonate Treat medically or surgically |
| Presentation of Persistent Ductus Arteriosus (PDA) | Asymptomatic Heart Failure Pulmonary hypertension |
| Clinical features of PDA | Continuous murmur under clavicle Bounding pulses |
| Management of PDA | Diuretics IBUPROFEN ACEi Ligation |
| Ductus arteriosus dependent lesions | Coarctation of the aorta Transposition of the great arteries Pulmonary stenosis/atresia Aortic stenosis/atresia |
| 3 Blocked Pipes | Pulmonary stenosis Aortic stenosis Coarctation of aorta |
| Pulmonary Stenosis | 8% Children are pink! Usually presents as a ejection systolic murmur Usually no symptoms May present with signs of heart failure |
| Aortic Stenosis | 5% Symptoms and clinical features depend on severity Symptoms more common than with PS ESM radiates to neck Thrills common |
| Presentation of coarctation of aorta | Poor feeding Lethargy Dyspnoea Headaches Calf pain |
| Clinical features of coarctation of aorta | Ejection systolic murmur between shoulder blades Absent/weak femoral pulses Gallop rhythm Radio-femoral delay Upper limb hypertension Collaterals |
| Management of coarctation of aorta | Prostaglandin E1 infusion Stenting Surgical repair |
| 3 Blue Babies | Tetralogy of Fallot Transposition of the Great Arteries ‘Complex’ CHD |
| The four parts of Tetralogy of Fallot | VSD Pulmonary Stenosis Overriding aorta RVH |
| Presentation of Tetralogy of Fallot | Cyanotic spells Cyanosis Squatting on exercise |
| Clinical features of ToF | Ejection systolic murmur LSE (Boot-shaped heart on CXR) |
| Management of ToF | Surgical repair at 6 months Cyanotic spell - morphine and beta-blocker |
| Presentation of Transposition of Great Arteries | Cyanosis Clubbing |
| Clinical features of ToGA | Cyanotic Death if not treated |
| Management of ToGA | Maintain ductus arteriosus Balloon atrial septostomy Arterial switch procedures |
| Presentation and Clinical Features of Left Hypoplastic Heart Syndrome (LHHS) | Presentation - Collapse Clinical Features - Shock within 72 hrs |
| Management of LHHS | Prostaglandin infusion Balloon atrial septostomy Staged repair using Norwood type procedure |
| Innocent murmurs | Most common at 3 – 4 years old Increases with fever/vary with posture The S’s : soft, systolic, sternal edge (localised), symptomless Normal HS |
| Define cyanosis | >5g/dl of deoxygenated Hb Impossible in profound anaemia Can reflect normality in polycythaemia |
| Symptoms of heart failure | Breathlessness (particularly on feeding or exertion) Sweating Poor feeding Recurrent chest infections. |
| Signs of heart failure | Poor weight gain or ‘faltering growth’ Tachypnoea Tachycardia Heart murmur, gallop rhythm Enlarged heart Hepatomegaly Cool peripheries |
| In the 1st week of life, what is the likely cause of heart failure? | Left heart obstruction, e.g. coarctation of the aorta Arterial perfusion may be predominantly by right-to-left flow of blood via the arterial duct |
| After the 1st week of life, what is the likely cause of progressive heart failure? | Left-to-right shunt During the subsequent weeks, as the pulmonary vascular resistance falls, there is a progressive increase in left-to-right shunt and increasing pulmonary blood flow -> pulmonary oedema + dyspnoea Such symptoms of heart failure will increase up to the age of about 3 months, but may subsequently improve (↑ pulmonary vascular resistance) |
| Regarding the previous flashcard, if the child is left untreated, what will they develop? | Eisenmenger syndrome Irreversibly raised pulmonary vascular resistance Results from chronically raised pulmonary arterial pressure and flow Now the shunt is from right to left and the teenager is blue |
| Clinical features of infective endocarditis | Fever Anaemia and pallor Splinter haemorrhages in nailbed Clubbing (late) Necrotic skin lesions Changing cardiac signs Splenomegaly Neurological signs from cerebral infarction Retinal infarcts Arthritis/arthralgia Haematuria (microscopic |
| Kawasaki disease | Systemic vasculitis Mainly affects children of 6 months - 4yrs (peak at the end of the 1st year) Can cause significant cardiac disease Aneurysms of the coronary arteries are a potentially devastating complication Echocardiogram may show: pericardial effusion, myocardial disease (poor contractility), endocardial disease (valve regurgitation) or coronary disease with aneurysm formation, which can be giant (>8 mm in diameter) |
| Clinical features of Kawasaki disease | Fever >5 days and four other features: - Non-purulent conjunctivitis - Red mucous membranes - Cervical lymphadenopathy - Rash - Red and oedematous palms and soles - Peeling of fingers and toes 'Incomplete' cases can occur, especially in infants |
| Treatment of Kawasaki disease | IV immunoglobulins Aspirin |
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