Term
|
Definition
1. Ductus venosus (bypasses liver)
2. Foramen ovale (R>L atrial shunt)
3. Ductus arteriosus (R>L arterial shunt) |
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Term
| Transitional circulation: |
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Definition
- Lungs expand within first few breaths
- Foramen ovale functionally closes
- Ductus arteriosus closes within 1 to 2 days |
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Term
| The foramen ovale becomes the __ __. |
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Definition
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Term
| The umbilical vein beomces the __ __. |
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Definition
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Term
| The ductus venosus becomes the __ __. |
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Definition
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Term
| The ductus arteriosum becomes the __ __. |
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Definition
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Term
| Acyanotic shunts are __ to __ shunts. |
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Definition
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Term
| Cyanotic shunts are __ to __ shunts. |
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Definition
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Term
| 3 types of acyanotic shunts: |
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Definition
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Term
| VSD and PDA usually present in __ with __ __, __, and __ __.There is usually __ __ enlargement. __ and __are transmitted. |
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Definition
- infancy
- heart failure
- murmur
- poor growth
- left heart enlargement
- Flow and pressure |
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Term
| ASD presents in __ with __ or __ __.There is __ __ __ usually __ __. Only __ is transmitted. |
|
Definition
- childhood
- murmur
- exercise intoleranc
- right heart enlargement
- right atrial
- flow |
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Term
| child presenting with murmur and exercise intolerance. acyanotic. murmur heard on exam: |
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Definition
| ASD (Acyanotic L to R shunt) |
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|
Term
| inant presenting with heart failure, poor growth, and murmur. |
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Definition
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|
Term
|
Definition
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Term
| VSD and PDA transmit __ and __, whereas ASD only transmits __. |
|
Definition
- flow and pressure
- flow |
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Term
| Holosystolic murmur at lower left sternal border with heave: |
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Definition
|
|
Term
| presentation and course of VSD depends on size of defect and the __ __ __. |
|
Definition
| pulmonary vascular resistance |
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|
Term
failure to thrive
tachypnea
diaphoresis with feeds |
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Definition
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Term
| Most common of all congenital heart conditions: |
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Definition
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Term
| Boudning pulse,machinery like murmur: |
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Definition
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Term
| 2nd most common congenital heart condition: |
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Definition
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Term
| ___ can be used in preterm infants to help a PDA to close, but doesn't seem to work in term infants. |
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Definition
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Term
| Indomethacin can be used to help cloe a __ in preterm infant. |
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Definition
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Term
|
Definition
- failure to thrive
- diaphoresis with feeds |
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Term
| infant with failure to thrive, holosystolic murmur at LLSB: |
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Definition
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|
Term
| infant with failure to thrive,bounding pulses, machinery like murmur: |
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Definition
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Term
|
Definition
- widely split fixed S2
- RV heave
- sytolic ejection murmur grade 1-3 at the pulmonary area
- large shunts cause a diastolic flow murmur at the LLSB (d/t increased flow across tricuspid valve)
- often asymptomatic |
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Term
| systolic ejection murmur heard best at the pulmonic area |
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Definition
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|
Term
| If you hear murmur at LLSB how do you distguish b/w VSD and ASD? |
|
Definition
- VSD would be holosytolic
- ASD would be diastolic |
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Term
| VSD and PDA cause __ heart enlargement, while ___ causes __ heart enlargement. |
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Definition
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Term
| Both VSD and ASD have increased __ __ __, but VSD has left heart enlargement, while ASD has right heart enlargement. |
|
Definition
| increased pulmonary blood flow |
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|
Term
| Cyanotic R>L shunts with increased PBF (pulmonary blood flow): |
|
Definition
- Truncus arteriosus
- Transposition of the great arteries (TGA) |
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|
Term
| Cyanotic R>L shunt with decreased PBF: |
|
Definition
- Tetralogy of Fallot
- Tricuspid atresia
- Ebstein's anomaly |
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|
Term
| Cyanotic R>L shunts like __ __ and __ of the __ __ are more likely to present with __ __. |
|
Definition
- truncus arteriosus
- transpostion of the the great arteries
- heart failure |
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|
Term
| With truncus arteriosus, there is extreme __ ___ and the pressures b/w the R and L ventricles are __. Thus o2 saturation can be as high a 93-94% due to the high ___ __ __. |
|
Definition
- pulmonary overcirculation
- equal
- pulmonary blood flow |
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Term
| Cyanotic R>L shunts with decreased pulmonary blood flow, like __ of __, are more likely to present with __. |
|
Definition
- Tetralogy of Fallot
- cyanosis |
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Term
| 4 aspects of Tetralogy of Fallot: |
|
Definition
- VSD
- Overriding aorta
- Pulmonary stenosis/atresia
- Left ventricular hypertrophy |
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|
Term
| Differential pulses or weak pulses in the lower extremities make you think: |
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Definition
|
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Term
|
Definition
| cardiogenic shock or coarction of the aorta |
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Term
|
Definition
- exaggerated systolic bp drop with inspiration
- cardiac tamponade
- severe asthma |
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Term
|
Definition
| - altering pulse strength due to left ventricle mechanical dysfunction |
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Term
|
Definition
| Mitral Valve Prolapse (MVP) |
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|
Term
|
Definition
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|
Term
|
Definition
- ASD
- Pulmonary stenosis |
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Term
|
Definition
| cardiac dysfunction or volume overload |
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|
Term
| muffled heart sounds and/or rub: |
|
Definition
| pericardial effusion +/- tamponade |
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Term
|
Definition
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Term
|
Definition
- turbulence begins with systole
- VSD
- MR |
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|
Term
| vibratory, twangy, systolic murmur heard besst at LSB and apex, loudest in supine position, decreases in upright position,grade 1-3 of 6: |
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Definition
|
|
Term
| where is Still's murmur heard best: |
|
Definition
| LSB and apex in supine position |
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|
Term
| An innocent pulmonary flow murmur is a __ __ murmur heard best over the __area. It is usually in __ __ and __. It is loudest when __ and may be heard in the __. |
|
Definition
- systolic ejection murmur
- pulmonic area
- older children and adolescents
- supine
- back |
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|
Term
| low pitched continuous hum heard best in the infraclavicular area: |
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Definition
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Term
| Venous hum is primary __. It disappears when the patient is __ or with compression of the __ __. |
|
Definition
- systolic
- disappears when pt is supine
- compression of jugular veins |
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|
Term
|
Definition
- Diastolic murmurs (only venous hum is okay
- Continuous murmurs (PDA) should be gone by 48 hours
- Loud murmurs, especially with thrills
- SYMPTOMS, esp. cyanosis |
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|
Term
| Number 1 cause of acquired heart disease: |
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Definition
|
|
Term
| systemic vasculitis of uknown etiology: |
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Definition
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|
Term
| Dx criteria for Kawasaki Disease: |
|
Definition
Fever for at least 5 days and 4 of the following 5 criteria:
- Eyes:bilateral conjunctival injection without exudates
- Lips and mouth: erythema, cracked lips, strawberry tongue
- Hands and feet: erythema and/or edema
- Skin: polymorphus exanthem
- Cervical lymphadenopathy: usually unilateral |
|
|
Term
| Lab findings of Kawasaki Disease: |
|
Definition
1. Moderate to high WBC with left shift
2. Anemia
3. Thrombocytosis
4. Increased CRP and ESR
5. Mild-moderate increase in transminases
6. Sterile pyuria |
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|
Term
| cardiac imaging study done for suspected KD; |
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Definition
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|
Term
|
Definition
|
|
Term
|
Definition
- IVIG 2g/kg
- ASA 80-100 mg/kg/day in 4 doses |
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|
Term
|
Definition
|
|
Term
| Acute Rheumatic Fever tmt: |
|
Definition
| - Penicillin G Benzathine 1.2 million units/month for 10 years or well into adulthood (this is to prevent rheumatic heart disease) |
|
|
Term
| rheumatic fever follows __ __ by about __ days or __ weeks. |
|
Definition
- Group A strep pharyngitis
- 18 days (2-6 weeks) |
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|
Term
| Earliest and most common feature of Rheumatic Fever: |
|
Definition
- painful migratory arthritis, affects 80%
- usually in larger joints: knees, ankles, shoulders, elbows |
|
|
Term
| Major Jones Criteria for Dx of Rheumatic Fever: |
|
Definition
- Carditis
- Migratory polyarthritis
- Chorea
- Subcutaneous nodules
- Erythema marginatum |
|
|
Term
| for polyarthritis to be part of rheumatic fever,it must be __ and involve _ or more joints. |
|
Definition
- migratory
- 2 or more joints |
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Term
|
Definition
anti-inflammatory agents
salicylates, corticosteroids
antibiotics - penicillin
600,000 U IM < 10 yo
1.2 million U IM, children > 10 yo, adults
erythromycin 250 mg PO qid x 10 days
chorea - sedatives
Prevention
penicillin, erythromycin |
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|
Term
|
Definition
- less than 460 msec in women
- less than 440 msec in men |
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|
Term
|
Definition
- disease of ion channels
- prolonged action potential
- early after depolarization
- increased sympathetic activity in heart (stellate ganglion) |
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|
Term
| Metabolic causes of acquired LQTS: |
|
Definition
- Hypokalemima
- Hypomagnesia
- Hypocalcemia
- Hypothyroidism
- Anorexia |
|
|
Term
| Medications that can cause acquired LQTS: |
|
Definition
- Antiarrhythmics: Sotalol, Amiodarone
- Antibiotics: Macrolides, Fluourquinoles
- Psychotropics: Haloperidol, TCAs, Thioridiine)
- Others: SSRIs, Risperidone, Methadone, Droperidoal, protease inhibitors |
|
|
Term
| good history questions if suspect congenital LQTS? |
|
Definition
- syncope
- deafness
- FHX of sudden cardiac death |
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|
Term
|
Definition
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|
Term
|
Definition
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|
Term
|
Definition
at rest/sleep
no benefit from beta blocker |
|
|
Term
| beta blockers are good for what types of LQTS? |
|
Definition
|
|
Term
| primary prevention with LQTS: |
|
Definition
- Beta blockers
- Avoidance of strenuous activities/sports
- Left cardiac sympathetic denervation? |
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|
Term
| Secondary prevention of LQTS; |
|
Definition
- beta blockers
- ICD
- avoidance of QT prolonging agents |
|
|
Term
| Hypertrophic obstsructive cardiomyopathy (HOCM) aka: |
|
Definition
- Idiopathic hypertrophic subaortic stenosis (IHSS)
- Hypertrophic cardiomyopathy |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| __ arrhythmias may occur with HOCM and cause sudden cardiac death, espcially in athletes. |
|
Definition
|
|
Term
|
Definition
- sudden cardiac death- VF
- dyspnea (90%)
- syncope or near syncope- esp with exercise
- presyncope- graying out
- chest pain
- palpitations
- reduced activity tolerance
- orthopnea
- paroxysmal nocturnal dyspnea |
|
|
Term
| crescendo decrescendo systolic ejection murmur heart b/w the apex and and LSB afer S1: |
|
Definition
|
|
Term
| HOCM murmur intensity is DECREASED by what? |
|
Definition
Maneuvers that increase ventricular volme
- handgrip
- passive leg elevation
- squatting from standing position |
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|
Term
| HOCM murmur is increased by what? |
|
Definition
Maneuvers that decrease ventricular volume:
- standing from squatting
- amyl nitrite
- valsalva maneuver |
|
|
Term
|
Definition
- ECHO FIRST: ventricular hypertertrophy
- Stress echo
- 24 holter monitor |
|
|
Term
|
Definition
- Beta blockers
- Calcium channel blockers
- Avoid dehydration
- Avoid strenuous exercise |
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|
