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What sound will accompany a patent ductus arteriosus?

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7 years ago

Date created

Mar 1, 2020

Cards (28)

Section 1

(28 cards)

What sound will accompany a patent ductus arteriosus?

Front

"Machine" murmur

Back

What does the GRADING of a murmur tell me?

Front

1. The intensity of how long the murmur is •Grade I - barely audible •Grade II - audible and constant •Grade III - loud without thrill •Grade IV - loud with thrill •Grade V - stethoscope just touching chest •Grade VI - stethoscope off chest

Back

How do we keep PDAs open?

Front

Prostaglandin

Back

A baby comes in with a murmur that we are worried about, what is the FIRST TEST we are going to want to order?

Front

1. Chest X-Ray

Back

What is the main illness that is associated with PDAs?

Front

Rubella

Back

What are the main features of INNOCENT and PATHOLOGIC murmurs?

Front

Back

What are the main heart sounds of ACYANOTIC problems?

Front

Back

Baby born 4 hours ago, baby breathing fast, Given pulse ox, --> 96%, are we concerned?

Front

1. WE ARE SOMEWHAT CONCERNED, it should be 99% or above 2. Anything above 92% if fine, but we need to take a listen and further inspection is warranted 3. If there is a little peripheral cyanosis, not a big deal

Back

How do we CLOSE PDAs?

Front

1. Indomethacin or Ibuprofen

Back

When we suspect an infant of a CHD, what are the symptoms we should look out for?

Front

1. Respiratory distress: grunting, head bobbing, nasal flaring, tracheal tug, retractions 2. Color: central vs peripheral cyanosis, pallor • 3. Precordial activity - Problem with portion of the body over the heart and lower chest 4. Dysmorphic features 5. Obtain a full set of vitals including heart rate, respiratory rate, blood pressure, and temperature 6. Blood pressure should be done in all 4 limbs (an average systolic discrepancy of > 10 mmHg in the lower limbs is significant)

Back

A baby is 6 months old and they are starting to present with respiratory issues, baby having trouble feeding, having trouble growing, what would be the problem?

Front

1. This would be a LEFT to RIGHT problem 2. Since that is LATE CYANOSIS

Back

What sound will accompany a coarctation of the aorta?

Front

1. Systolic Ejection Murmur 2. Beast at APEX 3. Systolic "Click"

Back

What are the main things that close in fetal circulation?

Front

1. DUCTUS ARTERIOSUS -Closes first few days of life -We can hear that murmur in baby until it closes 2. FORAMENT OVALE • The foramen ovale closes after birth as left-sided pressure exceeds right

Back

How would we diagnose a Ductus Arteriosus?

Front

1. Compare pre-ductal saturation (right arm) with post-ductal (either leg) to identify right to left shunting across the PDA

Back

What is the difference between a PPS and STILL'S murmur?

Front

1. PPS • Mid-systolic, blowing, high-pitched, low-intensity murmur best heard at the base with radiation to the back • Represents flow through the acute angle of branch pulmonary arteries 2. Still's • Low-pitched, low-intensity, vibratory systolic ejection murmur best heard at the lower left sternal border • Represents pulmonic valve leaflet vibration • More common in children than newborns

Back

What is the most COMMON CDH overall?

Front

VSD

Back

What lesions NEED ducts to stay open?

Front

Lesions with duct-dependent pulmonary circulation (pulmonary flow is supplied by aorta) usually present with cyanosis • Pulmonary atresia/stenosis • Severe tetralogy of Fallot • Tricuspid anomalies • TGA

Back

22 yo refugee from Venezuela, no prenatal care, G3/P2, -Just had baby, looks full term, not breathing well but not grunting, we see CENTRAL CYANOSIS, next step?

Front

1. PULSE OX!!!! 2. Then chest X ray(Remember that this will give me the SHAPE of the heart and help me narrow down TERRIBLE T Conditions) 3. Then Eco from cardiology

Back

What heart sound will accompany an atrial septal defect?

Front

1. BEAST at apex 2. S2 Ejection Murmur

Back

What are the duct dependent lesions that present with SHOCK?

Front

Hypoplastic left heart syndrome • Coarctation or severe aortic stenosis

Back

If a heart is making a crescendo-decrescendo, is that normal or not?

Front

NORMAL

Back

If it is a small VSD, what is the next step?

Front

1. Send them home, follow up in 6 months to make sure it is closing 2. This is only IF THE BABY IS GROWING and is FEEDING 3. HOWEVER, if we start to see issues with feeding, breathing, toddlers getting winded...it may not be closing

Back

What are the main risk factors for having a baby with CDH?

Front

1. DIABETES - VSD/Transposition 2. Rubella - Ductus Arteriosus problem 3. Alcohol -

Back

What are the main things we need to know for CYANOTIC heart disease?

Front

Back

Pt. comes in, 1 week old for check up, baby is well appearing, NON-cyanotic, breathing fine, We hear a SOFT MURMUR... -Next steps?

Front

1. Order Pulse Ox -We DO NOT need a chest x ray 3. Check femoral blood pressures, if we can't feel them, go to next step 2. Get extremity blood pressure MAIN POINT: Do the cheap and easy interventions

Back

What heart sounds will accompany a ventricular septal defect?

Front

Systolic Ejection Murmur

Back

If we suspect a duct dependent lesion?

Front

1. ECOCARDIOGRAM!! 2. Ducts don't stay open for too long so an eco will help confirm the diagnosis and get the pediatric cardiologist to look at child

Back

What is the prognosis of VSD?

Front

1. Depends on the SIZE A) small defect - tends to close spontaneously large defect w/o elevated pulmonary resistance (L --> R shunt) causes CHF, growth failure, and recurrent lower respiratory infections B) large defect with elevated pulmonary resistance (R --> L shunt = Eisenmenger) causes SOB, DOE, chest pain, syncope, and cyanosis

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