Shared Flashcard Set

Details

Cardio 17- Peds
Cardio
46
Medical
Professional
11/12/2012

Additional Medical Flashcards

 


 

Cards

Term
Atrial Septal Defect
Definition
1. Ostium Secundum - central interatrial septum
2. Ostium primum - low in septum
3. Sinus venous defects- high in septum
Term
Pathology of Atrial Septal Defect
Definition
-Oxygenated blood from LA --> RA
-Increased right heart output/ pulm blood flow
- Inc. work right side
-As shunt inc. in size, Right side dilates
-Pulm HTN rare but serious
Term
Presentation of Atrial Septal Defect
Definition
1. Mild systolic ejection murmur over pulm area, inc. pulm BFlow
2. Wide, fixed splitting of S2
3. Diastolic flow "rumble" murmur tricuspic
-RVF may be seen in advanced dz
Term
Atrial Septal Defect
Definition
1. Ostium Secundum - central interatrial septum
2. Ostium primum - low in septum
3. Sinus venous defects- high in septum
Term
Pathology of Atrial Septal Defect
Definition
-Oxygenated blood from LA --> RA
-Increased right heart output/ pulm blood flow
- Inc. work right side
-As shunt inc. in size, Right side dilates
-Pulm HTN rare but serious
Term
Presentation of Atrial Septal Defect
Definition
1. Mild systolic ejection murmur over pulm area, inc. pulm BFlow
2. Wide, fixed splitting of S2
3. Diastolic flow "rumble" murmur tricuspic
-RVF may be seen in advanced dz
Term
Dx Atrial Septal Defect
Definition
TEE- diagnostic
-CXR- large pulm arteries
-Echo w/ contrast - inject microbubbles and see cross via right -left shunt
-ECG- RBBB and Righ Axis Deviation, Afib or A-flutter
Term
complications of Atrial Septal Defect
Definition
-Einsenmenger's Disease- irreversible pulm HTN, shunt, heat failure
-Right Heart Failure
-Atrial Arrhythmias
-Stoke
Term
Tx Atrial Septal Defect
Definition
-Most do not require closure
-If very large or symptomatic, Sx repair
Term
Ventricular Septal Defect
Definition
-Most common congenital cardiac malformation
-Blood flows from LV --> RV through hole
Term
Pathology of Ventricular Septal Defect
Definition
-Inc. Pulm blood flow, shunt left to right b/c PulmVR< SystemicVR
-If PVR increases, shunt reverses
-Large defect = Pulm HTN
Term
Symptoms VSD
Definition
-small shunt asymptomatic
-large w/o elevated PVR = CHF, growth abnormalities, lower respiratory infections
-Large shunt w. high PVR (Eisenmenger's) : SOB, dyspnea w/ exertion, chest pain, syncope, cyanosis
Term
Signs of VSD
Definition
-Harsh, blowing holosystolic murmur w. thrill at 4th intercostal space
-Dec. murmur w. valsalva and handgrip
-Smaller defect = louder murmur
-Sternal lift from RV enlargement
-S2 inc. in intensity as PVR increases
Term
Ventricular Septal Defect
Definition
-Most common congenital cardiac malformation
-Blood flows from LV --> RV through hole
Term
Pathology of Ventricular Septal Defect
Definition
-Inc. Pulm blood flow, shunt left to right b/c PulmVR< SystemicVR
-If PVR increases, shunt reverses
-Large defect = Pulm HTN
Term
Symptoms VSD
Definition
-small shunt asymptomatic
-large w/o elevated PVR = CHF, growth abnormalities, lower respiratory infections
-Large shunt w. high PVR (Eisenmenger's) : SOB, dyspnea w/ exertion, chest pain, syncope, cyanosis
Term
Signs of VSD
Definition
-Harsh, blowing holosystolic murmur w. thrill at 4th intercostal space
-Dec. murmur w. valsalva and handgrip
-Smaller defect = louder murmur
-Sternal lift from RV enlargement
-S2 inc. in intensity as PVR increases
Term
Ventricular Septal Defect
Definition
-Most common congenital cardiac malformation
-Blood flows from LV --> RV through hole
Term
Pathology of Ventricular Septal Defect
Definition
-Inc. Pulm blood flow, shunt left to right b/c PulmVR< SystemicVR
-If PVR increases, shunt reverses
-Large defect = Pulm HTN
Term
Symptoms VSD
Definition
-small shunt asymptomatic
-large w/o elevated PVR = CHF, growth abnormalities, lower respiratory infections
-Large shunt w. high PVR (Eisenmenger's) : SOB, dyspnea w/ exertion, chest pain, syncope, cyanosis
Term
Signs of VSD
Definition
-Harsh, blowing holosystolic murmur w. thrill at 4th intercostal space
-Dec. murmur w. valsalva and handgrip
-Smaller defect = louder murmur
-Sternal lift from RV enlargement
-S2 inc. in intensity as PVR increases
Term
Dx VSD
Definition
-ECG- biventricular hypertrophy in pts w/ high PulmVR
-CXR - enlarged pulm arteries, enlarged cardiac silhouette
as PVR inc. heart size dec.
-Echo - see septal defect
Term
Complications of VSD
Definition
1. Endocarditis
2. Aortic Regurge
3. Heart Failure
4. Pulm HTN and shunt reversal
Term
Tx VSD
Definition
1. Asymptomatic w/ small defect, monitor
2. Sx repair if Pulm flow:systemic flow ratio >1.5:1
Term
What is coarctation of aorta?
Definition
Narrowing/constriciton of aorta (usually left subclavian origin), leads to obstruction btw proximal and distal aorta = Inc. Left ventricle afterload
Term
Presentation of Coarctation of Aorta
Definition
-HTN in UE w. hypotension in LE
-Upper body well developed, lower body under-developed
-High prevalence in Turner's syndrome
Term
Signs and S of Coarctation A
Definition
-Headache, cold extremeties, claudication w. exercise, leg fatigue
-Delayed femoral pulses compared to radial
Term
Dx Coarctation of A
Definition
1. ECG - LVH
2. CXR -notching of ribs
-Figure 3 appearance
Term
Complications of Coarctation of A
Definition
-Severe HTN
-Rupture of cerebral aneurysm
-Infective endocarditis
-Aortic dissection
Term
Tx Coarctation of Aorta
Definition
-Sx decompression
-Percutaneous ballon aortoplasty in some cases
Term
What is Patent Ductus Arteriosus
Definition
-Communication btw aorta and pulm artery after birth
-Normally closes within days after birth
-Left to Right shunt if remains
Term
What keeps PDA in fetal life
Definition
prostaglandins and low oxygen tension keep open
-blood is shunted away from nonfunctioning lungs
Term
PDA associated with?
Definition
Rubella syndrome
High altitude
Premature birth
Term
Pathology of PDA
Definition
-Large Left-right shunt : volume overload, pulm HTN, right-side heart failure
-late cyanosis
-can see reversal of blood flow
Term
Presentation of PDA
Definition
-Asymptomatic
-Signs right heart fail
-Loud P2- pulm HTN
-LVH- secondary to shunt
-RVH - secondary to pulm HTN
-Machinery murmur
-Wide pulse pressure, bounding peripheral pulses
-clubbing - toes especially
Term
Dx PDA
Definition
1. CXR - Inc pulm vascular markings
-dilated pulm artery
-enlarged cardiac silhouette
-calcification of ductus arteriosus sometimes
2. Echo -turbulent blood flow and patent ductus
Term
Tx PDA- w/o pulm vascular dz
Definition
Surgical ligation
Term
Tx PDA w. severe Pulm HTN or right-left shunt
Definition
Surgery contraindicated
-Indomethacin for closure, Prostaglandin E
Term
What is Tetralogy of Fallot
Definition
Triad of cardiac abnormalities:
1. Ventricular septal defect
2. RVH
3. Pulm artery stenosis and
4. overriding aorta
-Defect in development of infundibular septum
Term
Presentation of Tetralogy of Fallot
Definition
-Cyanosis- most common
-Tet spells - squat after exertion or crying spell to inc. SVR to shunt blood to lungs instead of aorta
-Crescendo-decrescendo murmur
Term
Dx TOF
Definition
1. Echo- best, defines 4 abnormalities clearly
2. EKG- may show enlarged RA and RV
3. CXR- classic "boot shaped heart"
4. Cardiac cath - to fully define anatomy
Term
Tx TOF
Definition
1. May need Oxygen, morphine, B-blocker if pt cyanotic
2. Surgical- w/in 1st of life
Term
What is Tetralogy of Fallot
Definition
Triad of cardiac abnormalities:
1. Ventricular septal defect
2. RVH
3. Pulm artery stenosis and
4. overriding aorta
-Defect in development of infundibular septum
Term
Presentation of Tetralogy of Fallot
Definition
-Cyanosis- most common
-Tet spells - squat after exertion or crying spell to inc. SVR to shunt blood to lungs instead of aorta
-Crescendo-decrescendo murmur
Term
Dx TOF
Definition
1. Echo- best, defines 4 abnormalities clearly
2. EKG- may show enlarged RA and RV
3. CXR- classic "boot shaped heart"
4. Cardiac cath - to fully define anatomy
Term
Tx TOF
Definition
1. May need Oxygen, morphine, B-blocker if pt cyanotic
2. Surgical- w/in 1st of life
Supporting users have an ad free experience!