ABP Pediatric Cardiology flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Holosystolic murmur VSD

A restrictive ventricular septal defect produces a loud holosystolic murmur at the left lower sternal border; a large unrestrictive defect may be quieter and present with heart failure.

Tetralogy hypercyanotic spell treatment

For a tetralogy spell, place the infant knee-chest, give oxygen, morphine, intravenous fluids, and phenylephrine; a beta-blocker can be used, and isoproterenol should be avoided.

Transposition ductal-dependent circulation

In d-transposition, systemic and pulmonary circulations run in parallel; prostaglandin E1 maintains mixing, and an arterial switch is usually performed within the first two weeks of life.

Ebstein anomaly echocardiographic hallmark

Ebstein anomaly shows apical displacement of the septal tricuspid leaflet by at least 8 mm/m² body surface area, causing a right atrialized ventricle and often an atrial shunt.

Kawasaki IVIG and aspirin

Kawasaki disease is treated with intravenous immunoglobulin 2 g/kg over 10–12 hours plus aspirin; echocardiography is obtained at diagnosis, at 2 weeks, and at 6–8 weeks.

Kawasaki coronary risk factors

Risk factors for coronary artery involvement in Kawasaki disease include age under 1 year, male sex, fever lasting more than 10 days, and failure to respond to initial intravenous immunoglobulin.

Acute rheumatic fever Jones criteria

Acute rheumatic fever diagnosis uses Jones criteria: evidence of preceding group A streptococcal infection plus two major or one major and two minor manifestations, with echocardiographic carditis supporting diagnosis.

Pericarditis ECG and pulsus

Acute pericarditis commonly causes positional chest pain, a friction rub, diffuse ST elevation with PR depression, and pulsus paradoxus when a pericardial effusion causes tamponade.

Adenosine SVT dose

For supraventricular tachycardia in a child, adenosine is given at 0.1 mg/kg rapid intravenous push, increasing to 0.2 mg/kg if needed; avoid in pre-excited atrial fibrillation.

Congenital complete heart block cause

Congenital complete atrioventricular block is associated with maternal anti-Ro/SSA or anti-La/SSB antibodies; pacing is indicated for symptoms, low ventricular rate, or ventricular dysfunction.

Long QT syndrome management

Long QT syndrome with QTc over 480 ms is managed with beta-blockers and avoidance of QT-prolonging drugs; an implantable cardioverter-defibrillator is considered after syncope or cardiac arrest.

Infant heart failure signs

Infant heart failure presents with tachypnea, feeding difficulty, poor weight gain, diaphoresis, hepatomegaly, and gallop rhythm; diuretics and afterload reduction are common initial therapies.

Hypertrophic cardiomyopathy precautions

In hypertrophic cardiomyopathy, avoid dehydration, intense vasodilation, and tachycardia; beta-blockers or calcium channel blockers are used, and sudden death risk prompts consideration of an implantable defibrillator.

Cardiac transplant rejection surveillance

After pediatric heart transplantation, rejection surveillance includes echocardiography and endomyocardial biopsy; coronary vasculopathy is detected by angiography or intravascular ultrasound and limits long-term survival.

Indexed pulmonary vascular resistance

Indexed pulmonary vascular resistance equals mean pulmonary artery pressure minus pulmonary capillary wedge pressure, divided by cardiac index; a value above 3 Wood units·m² is abnormal.

Acute vasoreactivity test

During acute vasoreactivity testing in pulmonary hypertension, inhaled nitric oxide, oxygen, or epoprostenol is used; a positive response predicts benefit from calcium channel blockers.

Eisenmenger syndrome management

Eisenmenger syndrome is pulmonary vascular disease with reversed shunt; avoid pregnancy and systemic vasodilators, and use pulmonary vasodilators and supplemental oxygen with careful monitoring.

Qp to Qs calculation

Qp:Qs equals systemic arterial oxygen saturation minus superior vena cava saturation, divided by pulmonary venous saturation minus pulmonary arterial saturation, measured during cardiac catheterization.

Cardiac MRI right ventricular volume

Cardiac magnetic resonance is the reference method for right ventricular volumes and function in tetralogy of Fallot; progressive dilation or dysfunction supports pulmonary valve replacement.

Echocardiographic z-score use

Z-scores express a cardiac structure's size relative to body surface area; a z-score beyond plus or minus two indicates abnormal size and guides decisions in congenital heart disease.

Ductus arteriosus closure timing

The ductus arteriosus functionally closes within 24 to 72 hours after birth and anatomically over weeks; patency is maintained with prostaglandin E1 in ductal-dependent lesions.

Fetal echocardiography timing

Fetal echocardiography is usually performed between 18 and 22 weeks gestation; earlier or later studies are used for high-risk families, abnormal screening, or arrhythmia.

Pulse oximetry newborn screening

Newborn critical congenital heart disease screening uses preductal and postductal oxygen saturation; a difference above 3% or saturation below 90% requires prompt echocardiography.

Milrinone mechanism and use

Milrinone is a phosphodiesterase-3 inhibitor that increases contractility and causes vasodilation; it is used for low cardiac output after congenital heart surgery but can cause hypotension.

ECMO in pediatric cardiac failure

Extracorporeal membrane oxygenation provides temporary circulatory support for refractory low cardiac output, cardiac arrest, or hypoxemia; bleeding, infection, and neurologic injury are major complications.

Delayed sternal closure indications

Delayed sternal closure is used when myocardial edema, bleeding, or arrhythmia makes chest closure unsafe after congenital heart surgery; staged closure follows in the intensive care unit.

22q11 deletion cardiac features

The 22q11.2 deletion causes conotruncal anomalies including tetralogy of Fallot, truncus arteriosus, and interrupted aortic arch, plus hypocalcemia and immunodeficiency.

Williams syndrome cardiovascular lesion

Williams syndrome, caused by a 7q11.23 deletion, commonly causes supravalvar aortic stenosis and peripheral pulmonary stenosis; it also features elfin facies and hypercalcemia.

Marfan syndrome aortic surveillance

Marfan syndrome, from FBN1 mutations, causes aortic root dilation; beta-blockers or angiotensin receptor blockers and serial imaging aim to prevent dissection, with surgery for severe dilation.

I-PASS handoff components

The I-PASS handoff includes illness severity, patient summary, action list, situation awareness, and contingency planning, plus synthesis by the receiver; it reduces communication errors.

Root cause analysis purpose

Root cause analysis examines systems factors behind a serious safety event, identifies contributing causes, and produces action plans; it is nonpunitive and distinct from individual performance review.

PDSA quality improvement cycle

The Plan-Do-Study-Act cycle tests a small change, studies the result, and adjusts before broader implementation; repeated cycles support measurable improvement in clinical processes.