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cardiovascular_congenital heart disease ((ductus arteriosis close, foramen…
cardiovascular_congenital heart disease
tetralogy of Fallot
(pulmonary stenosis, right ventricular hypertrophy)
(large VSD, overriding aorta)
investigations
ECG: right ventricular hypertrophy
echocardiography
CXR: boot-shped heart (right ventricular hypertrophy)
management
Blalock-Taussig shunt (pulmonary artery & subclavian artery)
surgical repair
antibiotic prophylaxis of infective endocarditis
clinical features
left sternal border: ejection systolic murmur :smiley: parastenal heave: right ventricular hypertrophy
cyanotic heart disease
(right-to-left shunt)
cyanosis
hypercyanotic spells
hyperoxia test/nitrogen washout test
central, peripheral cyanosis
Eisenmenger syndrome
left-to-right shunt e.g. VSD
pulmonary hypertension
right-to-left shunt
transposition of great arteries
ventricular septal defect
clinical features
left lower sternal border: pansystolic murmur :smiley: apex: mid-diastolic murmur, loud P2
investigations
CXR (cardiomegaly, increase pulmonary vascular markings), ECG (biventricular hypertrophy), echocardiograhy
management
diuretics surgical repair
cyanosis + heart failure (atrioventricular septal defect)
patent ductus arteriosus
clinical features
left infraclavicular: continuous murmur
investigations
CXR (normal), ECG (normal), echocardiography
management
surgical ligation antibiotic prophylaxis of infective endocarditis
acyanotic heart disease
(left-to-right shunt)
heart failure
failure to thrive
furosemide
poor weight gain
IV captopril, spironolactone
poor feeding
resuscitation, vitals
hepatomegaly
tachypnea
tachycardia
sweating
atrial septal defect
clinical features
left upper sternal border: ejection systolic murmur :smiley: fixed splitting of second heart sound
investigations
CXR (cardiomegaly, increase pulmonary vascular markings), ECG (RBBB, right axis deviation), echocardiography
management
trans-catheterization of occlusion device surgical repair
ductus arteriosis close
foramen ovale close
left > right
separated from placenta (decrease blood to right atrium)
1st breath, decrease resistance of pulmonary vessels (increase left atrial pressure)
obstruction: asymptomatic (pulmonary stenosis)
clinical features
left upper sternal border: ejection systolic murmur :smiley: parasternal heave: right ventricular hypertrophy
investigations
CXR (post-stenotic dilation of pulmonary artery), ECG (right ventricular hypertrophy), echocardiography
management
trans-catheter balloon dilation
obstruction: asymptomatic (aortic stenosis)
clinical features
(exertional dyspnea, exertional chest pain, exertional syncope) right upper sternal border: ejection systolic murmur :smiley: radiating to neck small volume, slow rising pulse
investigations
CXR (post-stenotic dialtion of aorta), ECG (left ventricular hypertrophy), echocardiography
management
trans-catheter balloon valvotomy
obstruction: shock (coarctation of aorta)