Term
| ____ is heard with closure of the mitral and tricuspid valves? |
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Definition
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Term
| ____ is heard with closure of the aortic and pulmonary valves? |
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Definition
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| ____ is heard in early diastole and is related to rapid ventricular filling. May be normal. |
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Definition
| S3; A loud S3 is abnormal and heard in conditions with dilated ventricles. |
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Term
| S4 is rare and is always _____? |
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Definition
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Term
| The presence of a good pedal pulse and normal right arm blood pressure effectively rules out what condition? |
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Definition
| rules out coarctation of the aorta |
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Definition
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| A mid-systolic click is associated with _____? |
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Definition
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| ______ arrhythmia is a common finding in children and represents a normal variation in the heart rate associated with breathing. The heart rate increases with inspiration and decreases with expiration, producing a recurring pattern on the ECG tracing. |
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Definition
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Term
| SVT in infants is often _____ beats/min? |
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Definition
| 280 to 300 beats/min; SVT is the most common symptomatic arrhythmia in pediatric patients. |
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Term
| A 2 month old infant presents to your clinic with fatigue, diaphoresis with feedings and poor growth. You hear a pansystolic murmur at the LLSB. What dx is most probable? |
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Definition
| The infant most likely has a VSD. These are not typically symptomatic at birth. |
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Term
| ASDs represent approximately ____% of all congenital heart defects. A ______ defect, with the hole being in the region of the foramen ovale, is the most common ASD. |
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Definition
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| A mother brings her 3 month old healthy infant into your clinic for a regular checkup. During your PE you notice the infant has a grade II systolic ejection murmur in the region of the right ventricular outflow tract and a fixed split S2. What dx is most likely? |
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Definition
| Atrial Septal Defect; An S2 is supposed to be split on inspiration but single on expiration. |
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Term
| Allow blood to flow from the pulmonary artery to the aorta during fetal life. Failure of the normal closure of this vessel results in a _____? |
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Definition
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Term
| A 2 month old infant presents to your clinic with symptoms of CHF. On PE you notice a widened pulse pressure and a continuous machine-like murmur at the left infraclavicular area, that is also well heard over the infants left back. What is the most likely dx? |
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Definition
| Patent Ductus Arteriosus (PDA) |
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Term
| Endocardial Cushion Defect is also known as _______. What are the heart defects? |
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Definition
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Term
| Pulmonary hypertension is heard as a ________? |
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Definition
| Prominent S2; This may be heard if an infant has an endocardial cushion defect. |
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Term
| Too much pulmonary blood flow can be caused by left-to-right shunts. The most common of these is VSD, ASD, & PDA. What will you see in a chest X-ray in someone with pulmonary hypertension? |
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Definition
| A full pulmonary artery silhouette, increased pulmonary vasculature, & right ventricle hypertrophy. |
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Term
| _____ is the most common congenital heart defect? |
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Definition
| VSD; accounting for 25% of all congenital heart disease. |
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Term
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Definition
| 35% close spontaneously. Even if it doesn't close surgery may not be needed. However, prophylactic antibiotics ARE needed to prevent bacterial endocarditis. Also, moderate to large VSD's get diuretics and digoxin. |
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Term
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Definition
| Tx is rarely indicated. Nonsecundum (non foramen ovale) ASD's get prophylactic antibiotics to prevent bacterial endocarditis. If there is still a large shunt >3 yrs old, closure is recommended. |
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Term
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Definition
| Most all eventually require surgical closure. Moderate and large PDA's are initially managed with diuretics and digoxin. |
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Term
| What is the tx for endocardial cushion defect? |
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Definition
| Initially diuretics and digoxin. But all eventually require surgical repair. |
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Term
| What disorder reveals cardiomegaly with enlargement of a 4 chambers on chest xray and in increased vascularity, along with left axis deviation on ECG? |
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Definition
| Endocardial cushion defect |
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Term
| A mother brings her young child into your clinic b/c he is becoming more and more easily fatigued and SOB when he runs and plays. Upon your PE you hear a systolic ejection murmur at the second left intercostal space (P2), which radiates to the back. What dx would you most likely consider? |
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Definition
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Term
| What is the tx for pulmonary stenosis? |
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Definition
| Balloon valvuloplasty or surgery if that is unsuccessful. |
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Term
| A mother brings her young child to your office worried b/c her child is easily fatigued & has chest pain when he runs and plays. He has fainted twice recently. Upon PE a systolic ejection murmur is heard at the right second intercostal space along the sternum and radiating into the neck. Chest Xray shows left ventricular hypertrophy. What is a likely dx? |
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Definition
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Term
| What would you see in a chest xray in a child with aortic stenosis? |
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Definition
| Left ventricular hypertrophy and Poststenotic dilation of the ascending aorta or aortic knob. |
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Term
| What is the tx of Aortic stenosis? |
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Definition
| Balloon valvuloplasty first, then surgery if that is unsuccessful. Antibiotic prophylaxis to prevent bacterial endocarditis throughout the child's life. |
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Term
| A neonate with a hx of poor feeding, is now in respiratory distress and shock. After stabilizing the infant, on PE you notice the femoral pulses are weaker than the radial pulses, and BP is decreased in the lower extremities compared to the upper extremities. What dx would you first think of? |
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Definition
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Term
| _______ may also be seen in older children (>8 years old) with large collaterals. |
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Definition
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Term
| Older children presenting with coarctation of the aorta are usually asymptomatic, although there may be a history of....? |
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Definition
| leg discomfort with exercise, headache, or epistaxis |
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Term
| prostaglandin E1 does what? |
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Definition
| It chemically opens the ductus arteriosum. It is used in infants presenting with cardiac decompensation. |
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Term
| What are the 4 structural defects of Tetralogy of Fallot? |
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Definition
| VSD, pulmonary stenosis, overriding aorta and right ventricular hypertrophy |
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Term
| Which defects show on an ECG as right axis deviation? Left Axis deviation? |
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Definition
| Right Axis: ASD, Pulmonary Stenosis, Tetralogy of Fallot, Transposition of the Great Arteries, Total Anomalous Pulmonary Venous Return....Left axis: Endocardial cushion defect |
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Term
| Xray shows "egg on a string" |
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Definition
| transposition of the great arteries |
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Term
| Xray shows a "boot-shaped" heart |
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Definition
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Term
| A neonate is severely cyanotic, has a single S2, and chest xray show left ventricular hypertrophy and decreased pulmonary blood flow. What is the most likely dx? What is the tx? |
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Definition
| Tricuspid atresia; Blalock-Taussig procedure typically followed by a two-stage procedure (bidirectional Glenn and Fontan procedure), which directs systemic venous return directly to the pulmonary arteries. |
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Term
| Which congenital heart condition does this describe: Anatomically a single arterial trunk arises from the heart with a large VSD immediately below the truncal valve. |
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Definition
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Term
| A neonate is cyanotic, has signs of CHF, and has bounding peripheral pulses. What condition does this describe? |
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Definition
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Term
| What congenital heart condition does this describe? Anatomically, all of the pulmonary veins fail to connect to the left atrium and return abnormally via the right heart. |
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Definition
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Term
| What congenital heart condition does this describe? A neonate with poor growth, minimal cyanosis, a continuous murmur, a hyperactive right ventricular impulse with a widely split S2, and a systolic ejection murmur at the left upper sternal border. |
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Definition
| Non-obstructive Total anomalous pulmonary venous return; The obstructive version of this condition presents with much worse cyanosis, dyspnea, and hepatomegaly. |
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Term
| ECG is consistent with right ventricular volume overload. Cardiomegaly with increased pulmonary blood flow is seen on chest x-ray. |
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Definition
| Total anomalous pulmonary venous return |
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Term
| Chest Xray shows decreased pulmonary blood flow & hypoplastic right ventricle: |
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Definition
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Term
| Bounding peripheral pulses: |
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Definition
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Term
| Right ventricular volume overload, increased pulmonary blood flow, & right ventricular hypertrophy |
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Definition
| Total Anomalous Pulmonary Venous Return |
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Term
| Classically the femoral pulses are weaker and delayed compared with the radial pulses & the BP in the lower extremities is lower than in the upper extremities. |
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Definition
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Term
| A chest xray reveals cardiomegaly with enlargement of all four chambers... |
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Definition
| Endocardial cushion defect |
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Term
| A widened pulse pressure & continous machine like murmur... |
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Definition
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