Exam 2 Flashcards
cough in infant < 3months
cardiac defect (shunts blood into lungs - VSD, ASD, hypo plastic lt heart, TAPVR)
pertussis
bronchiolitis
Serious: infants have high threshold for reflexive cough < 3 months
symptoms indicative of excess blood in lungs (often occurs at 4-6 weeks when pull. vascular resistance drops)
tachypnea, cyanosis, coughing, CHF
innocent murmur that is only heard on back
peripheral pulmonary stenosis
only cardiac defect with murmur that radiates to back
pulmonary stenosis
Note: TOF has pulmonary stenosis as part of it, so this will also radiate to back
most common murmur in NICU graduates (premature infants)
patent ductus arteriosa (PDA)
cardiac defects at risk for Eisenmenger syndrome
VSD
PDA
two ductal dependent murmurs
hypo plastic left heart
coarctation of aorta
most common murmurs
most common: VSD
common: ASD, VSD, TOF
most common continuous: PDA
“boot shaped heart” on CXR
tetralogy of fallot (TOF)
“egg on a string” on CXR
transposition of great vessels
“snowman” on CXR
total anomalous pulmonary venous return (TAPVR)
treatment to keep ductus arteriosa open
prostaglandins (PGE1)
treatment to close ductus arteriosa
NSAIDS (IV Ibuprofen)
- avoid in 3rd trimester
cardiac defects with no murmur
hypoplastic left heart syndrome
total anomalous pulmonary venous return (TAPVR)
transposition of great arteries
- ASD and VSD are so large
cardiac murmurs - when to refer and urgency of referral
any child with grade 3/6 or louder murmur
any child with holosystolic murmur
<2 m/o w/ murmur + concerning hx and PE
- IMMEDIATE REFERAL
<3wks w/ grade 1-2 murmur and no concerning hx and PE
- can re-check weekly
- call cardiologist if not resolved in 4 weeks
older, stable child (and unsure of positional change test):
screen with EKG
- normal: observe
- abnormal: refer
