Transcript Board Review Cardiology

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Venous hum: turbulent flow in yugular vein
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Hypertrophic cardiomyopathy
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VSD
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ASD
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PS
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Endocarditis prophylaxis ONLY FOR PTS WITH:
a prosthetic heart valve
Hx of previous endocarditis
Hx of complicated unrepaired cyanotic congenital heart disease, or s systemic to
pulmonar artery shunt or conduit
Repair of congenital heart defect with prosthetic material < 6months ago
Residual defects following repair of a congenital heart lesion
Procedures that require prophylaxis
Tooth extraction
Tonsillectomy/ adenoidectomy
Dental implants
Periodontal or endodontal procedures
Surgical procedures involving the respiratory mucosa
GIVE AMOXICILLIN 50MG/KG max 2gr, 1 HR PRIOR
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PPS
Common in newborns, resolved by 2-3 months
II/VI systolic murmur best on LUSB, radiating to posterior lung fields and
axillae
Due to turbulent flow at the origin of the small branch pulmonary
arteries as they exit the large main pulmonary artery
•Pulmonary flow: systolic ejection murmur best in LUSB
•turbulant flow where main pulmonary artery connects with RV
•Vibratory or “still” murmur: II/VI mid systolic murmur heard best on LLSB
and apex
•blood flow in the LV that leads to vibrations in the ventricle or mitral
structure
•toddlers, school age
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S4 rare in kids, better when pt supine or L lateral
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S3
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during diastole ventricle fills up in 2 phases: early passive blood flow from
atria  vibration of ventricular walls and later a vigorous atrial ejection
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HTN or severe anemia
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Heard best with bell with pt on L lateral recumbent position
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Apical systolic murmur associated with a mid-systolic apical click
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Anorexic bradycardia, weak irregular pulses and hypotension
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VSD
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ASD
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PDA
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Best on left 2nd intercostal space, wide pulse pressure and
bounding pulses
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Coartation of aorta
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TOF
VSD ASD coartation of aorta PDA
TOFpulmonary valve stenosis aortic
valve stenosis transposition of the great
arteries hypoplastic LV
For Boards:
Baby 3-4wks old coming with signs of shock, r/o VSD as cause
of CHF
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A narrow mediastinum associated with mild cardiomegaly
Marked cardiomegaly associated with increased pulmonary vascularity
Normal heart size with decreased vascular markings
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Stage One
Blalock-Taussig (BT) shunt: first few
days after birth, and establishes a
systemic-to-pulmonary artery shunt
between the brachiocephalic artery or
the right subclavian artery, to the right
pulmonary artery via (usually) a
tubed homograft or synthetic graft.
Glenn Procedure or Hemi-Fontan:
usually performed at 4-6 months after
birth as a bridge to Fontan
completion. The BT shunt and
pulmonary artery band is usually
removed. The superior vena cava is
then attached to right pulmonary
artery, creating a systemic venous-topulmonary connection.
Fontan Completion: Usually
performed at 2-3 years of age; the
inferior vena cava is connected to the
right pulmonary artery via a tunnel
like patch within the right atrium
(Lateral Tunnel Fontan), or by
creating a conduit for IVC flow outside
the right atrium (Extracardiac
Fontan).
Decreased vascular markings associated
with a “boot-shaped” heart
Pulmonary edema associated with cardiac enlargement
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