Term
| hallmarks of innocent murmurs |
|
Definition
asymptomatic pt
soft blowing murmur
systolic murmur
left sternal edge |
|
|
Term
| what are the left to right shunts? |
|
Definition
|
|
Term
| a fixed widely split S2 implies what? |
|
Definition
|
|
Term
|
Definition
pansystolic murmur at LLSE
loud murmur implies smaller defect
no pulmonary HTN
lesions close spontaneously |
|
|
Term
ejection systolic murmur best heard at upper left sternal edge
fixed splitting of s2
what is it? |
|
Definition
ASD
if there is a pan systolic murmur at apex then this is partial AVSD
mx: catheter device closue for secundum ASD
surgery for partial AVSD. both done at 3years. |
|
|
Term
| continous murmur at upper left sternal edge with bounding pulses. what defect am i? |
|
Definition
|
|
Term
| describe the murmur of VSD |
|
Definition
| pansystolic murmur and left lower sternal edge |
|
|
Term
| what is different between a small and large VSD? |
|
Definition
small VSD murmur louder and no pulmonary HTN
large VSD, quiete murmur and presence of pulmonary HTN. |
|
|
Term
| what is the hyperoxia nitrogen washout test? |
|
Definition
used to determine the presence of heart disease in a cyanosed neonate
place infant in 100% for 10mins
if right radial artery PaO2 from ABG remains low <15kPa after this time then a diagnosis of cyanotic congenital heart disease is made. |
|
|
Term
| signs of tetralogy of fallout on CXR? |
|
Definition
| boot shaped heart and concave pulmonary artery bay on the left hand side. |
|
|
Term
| if CXR reveals a narrow upper mediastinum with an egg on the side appearance of the cardiac shadow what are you thinking? |
|
Definition
| transposition of the great arteries. |
|
|
Term
| name 3 cyanotic congenital heart disease |
|
Definition
TOF
TGA
eisenmengers syndrome |
|
|
Term
| list the left to right shunts |
|
Definition
ASD partial and secundum
VSD small and large
PDA |
|
|
Term
| name cyanotic congenital heart disease |
|
Definition
TOF
EISENMENGERS
TGA
these are also call right to left shunts |
|
|
Term
| name common mixing heart conditions |
|
Definition
AVSD
complex disease e.g. tricuspid atresia |
|
|
Term
| causes of outflow obstruction in a well child |
|
Definition
aortic stenosis
pulmonary stenosis
adult type coarction of aorta |
|
|
Term
| left heart outflow obstruction in a sick child - duct dependent lesions |
|
Definition
coarction of aorta
interruption of aortic arch
hypo plastic left heart syndrome |
|
|
Term
| what is important in duct dependent lesions? |
|
Definition
| prostaglandin infusion to keep the PDA open. |
|
|
Term
| how would you use the pulse to differentiate between hypo plastic left heart syndrome and correction of the aorta? |
|
Definition
there is weakness or absence of all pulses in hypo plastic left heart syndrome
in coarction of aorta there are weak femoral pulses. |
|
|
Term
| mx of hypo plastic left heart syndrome? |
|
Definition
neonatal Norwood procedure
followed by glenn or Hemi Fontan at ~6 months and
again Fontan at 3 years |
|
|
Term
| describe the cyclical change in heart rate with respiration |
|
Definition
acceleration with inspiration
slowing on expiration |
|
|
Term
| rx of complete heart block |
|
Definition
infants usually have anti-to and anti-la antibodies
all children with symptoms need endotracheal pacemaker |
|
|
Term
| features of long QT syndrome |
|
Definition
AD inheritance with many phenotypes
has been associated with erythromycin therapy, electrolyte disorders and head injury |
|
|
Term
| jones criteria what is needed to diagnose endocarditis? |
|
Definition
two major
or
one major and two minor |
|
|
Term
| major manifestations of endocarditis jones criteria |
|
Definition
pancarditis
polyarthritis
sydenham chorea
erythema marginatum
subcutaneous nodules: mainly on extensor, painless |
|
|
Term
describe the erythema marginatum rash
which condition is it found in? |
|
Definition
rash on trunks and limbs
pink macules spread outwards causing pink border with fading centre
borders may unite to give a map like outline |
|
|
Term
| describe features of the minor jones criteria |
|
Definition
fever
polyarthralgia
hx of rheumatic fever
raised acute phase reactant, ESR, CRP leucocytosis
prolonged PR interval on ECG |
|
|
Term
| what is the most common murmur in IE? |
|
Definition
|
|
Term
| how should blood cultures be taken to ix IE? |
|
Definition
3 sets of bloods from peripheral sites with at least 6 hours between them before Abx have been commenced
in those with acute presentation and septic shock take 2 sets of cultures within different times of the hour before starting ABx |
|
|
Term
| what is required from the modified DUKES criteria to diagnose IE? |
|
Definition
two major or
one major 3 minor or
5 minor |
|
|
Term
|
Definition
positive blood culture from 2 sets
evidence of endocardial involvement
positive echo for IE |
|
|
Term
| mx for native valve endocarditis? |
|
Definition
| amoxicillin and gentamicin |
|
|
Term
| mx for prosthetic valve endocarditis? |
|
Definition
| vancomycin, gentamicin and rifampicin |
|
|
Term
|
Definition
| due to vegetations on mitral valve in IE |
|
|
Term
|
Definition
| due to severe aortic regurg |
|
|
