Term
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Definition
- Diastolic - NEVER INNOCENT
- Still’s murmur : low pitched, vibratory, systolic ejection, increases with the supine position.
- Venous hum: continuous murmur in supraclavicular region, reduces on lying down or with pressure on neck. |
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Term
| Structural Heart Disease - Pink vs. blue |
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Definition
Pink - Shunts
- ASD, VSD, PDA
Pink - Stenosis
- AS, PS, Coarctation, HLHS
BLUE
- TOF, TGA, tricuspid atresia, truncus, TAPVR, ebstein's, single ventricle |
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Term
| Atrial Septal Defect (ASD) |
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Definition
- 3 types: secundum is most common, others are primum and sinus venous
- sx: NONE, or exercise intolerance in childhood, arrhythmias and pulmonary obstructive vascular disease in 30s
- murmur: 2-3/6 SEM at the ULSB and a fixed wide split S2
- RVA, EKG = RAD and IRBBB |
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Term
| What is the most common congenital heart defect? |
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Definition
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Term
| Ventricular Septal Defect (VSD) |
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Definition
**MOST COMMON CHD**
o 4 types: muscular, perimembranous, inlet, outlet
o LVE and CHF, pulmonary infections, and delayed growth w/ large VSD (may also lead to Eisenmenger’s syndrome), nothing with small
• Eisenmenger's syndrome: the process in which a left-to-right shunt caused by a ventricular septal defect in the heart causes increased flow through the pulmonary vasculature, causing pulmonary hypertension,[1] which in turn, causes increased pressures in the right side of the heart and reversal of the shunt into a right-to-left shunt.
o Murmur: Loud 4-5/6, harsh holosystolic murmur, middiastolic rumble and a loud P2
o EKG: LVH or BVH
- close spontaneously depending on where
o Tx: SURGERY @ 4-6 mo., diuretics, digoxin, and afterload reducing agents beforehand if needed |
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Term
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Definition
*****1/3rd of babies with this have Down syndrome – know this
EKG : Characteristic with a superior left axis.
Echo : Confirmatory
Management : Anticongestive medications and surgery at 4-8 months of age. |
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Term
| 1/3 of babies with this defect have down syndrome? |
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Definition
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Term
| Treatment for PDA in a newborn? |
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Definition
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Term
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Definition
o Connection btwn aorta and pulmonary artery (COMMON IN PRETERM) – closes in first 2 weeks
o Sx: small – none; large – CHF at 6-8 wks, preterm baby increasing respiratory support after 3 days
o Murmur: newborn – systolic, older child – continuous “train in a tunnel” – BEST HEARD BELOW LEFT CLAVICLE
o Large, causes LA and LVE
o Tx: preterm – use indomethacin( KNOW THIS!!!) , term – if still open at 3 months, coil closure by cardiac cath |
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Term
| Treatment of PDA in 3 month old (if still open)? |
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Definition
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Term
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Definition
juxtadiuctal, most also have bicuspid aortic valve
o Sx: SEVERE : Shock
• MODERATE : CHF, MILD : Headaches, leg claudication
o DECREASED FEMORAL PULSES ESP IN NEONATES (BP lower in the lower limbs)
o Tx: for infant in shock – PGE1 immediately |
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Term
| What is important to look for in coarctation of the aorta? |
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Definition
| - decreased femoral pulses |
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Term
| Transposition of the great arteries |
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Definition
aorta in RV and PA in left
o Sx: cyanosis and cardiomegaly
o Murmur: maybe none
blood cycles through body; other side blood cycles through lungs
- u can tell because when u put oxygen on the kid, oxygenation does not improve
- when PDA closes, there is no mixing, theyre screwd. |
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Term
| Hypoplastic left heart syndrome |
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Definition
o Babies are in cardiogenic shock when ductus closes;
o Tx: PGE1 IV, surgery (3 different ones – initial, 6 months, and 2 yrs) |
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Term
| Which is the most severe heart defect? |
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Definition
| HYPOPLASTIC LEFT HEART SYNDROME |
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Term
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Definition
o Sx: none in mild or moderate, cynanosis only with critical PS
o Signs: ejection click and harsh SEM at ULSB
o Tx: balloon valvotomy if RV pressure is over 50 mmHg (valvuloplasty) |
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Term
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Definition
AT, BEFORE, or AFTER valve
o WORSE THAN PULMONIC STENOSIS
o Valvar = bicuspid aortic valve
o MOST COMMON CAUSE OF SUDDEN DEATH IN KIDS = Subvalvar AS (HCM)
o Sx: Mild – NONE, moderate to severe – chest pain, fatigability, syncope |
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Term
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Definition
o Tet = pulmonary stenosis, RVH, overriding aorta, VSD
o Sx: cyanosis, murmur, squatting, and spells
o ***TET SPELL = rapid breathing and increased cyanosis initiated by crying or increased physical activity
• tx: hold the baby in a knee chest position, morphine, oxygen, beta blocker, general anesthesia |
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Term
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Definition
| pulmonary stenosis, RVH, overriding aorta, VSD |
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Term
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Definition
- coarctation of the aorta
- hypo plastic left heart syndrome |
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Term
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Definition
| - aortic stenosis, pulmonic stenosis, and ASD |
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