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    ZS Pediatric Cardiology

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    Zeyad Saleh
    summary of most common pediatric illness in cardiology branch

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    ZS Pediatric Cardiology

    Uploaded by

    Zeyad Saleh
    2 views4 pages
    summary of most common pediatric illness in cardiology branch

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    © © All Rights Reserved

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    PDF, TXT or read online from Scribd

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    summary of most common pediatric illness in cardiology branch

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    2 views4 pages

    ZS Pediatric Cardiology

    Uploaded by

    Zeyad Saleh
    summary of most common pediatric illness in cardiology branch

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 4

    Pediatric Cardiology

    VSD :
    Etiology Defect in intraventricular septum
    (membranous/muscular)
    Path. Left to right shunt (during systole)>lung plethora>
    Biventricular enlargement > Eisenmenger
    C/P Small : Asymptomatic + pansystolic murmur
    Large : Feeding difficult - extensive sweating -
    Dyspnea - Recurrent Chest infection
    Symptoms Congestive Lung symptoms (Due to Plethora)
    Ex (May) Pericardial bulge
    Systolic thrill (Lt parasternal)
    Accentuated S2 (if PHTN)
    Pansystolic Harsh murmur at Lt parasternal to All
    over pericardium
    Complications HF-IEC-Recurrent chest infections-PHTN-
    Eisenmenger -Failure to thrive
    Dx CXR-ECG-ECHO
    ttt Surgical : if membranous - Large defect - unclosed
    defect until 10 yrs
    IEC prophylaxis

    Tetralogy of Fallot :
    Etiology PS +Big VSD +Overriding Aorta + RVH
    Path. • PS > Decrease pulmonary perfusion (lung
    oligemia)
    • Aorta overriding > Cyanosis
    • Non Functioned Shunt (due to equal pressure)
    • Duct dependent
    Symptoms Cyanosis
    Lung Oligemia
    C/P Cyanosis (usually late/severe cases/Absent (Pink
    Fallot))
    Cyanotic spells
    Dyspnea
    Squatting position
    Clubbing
    Ex Harsh ejection systolic Murmur over Lt
    parasternal area
    Uncommon thrill over Lt parasternal single S2
    Complications Cyanotic spells - TB - Polycythemia (Thrombosis) -
    Brain Abscess - Growth retardation - Rarely HF
    and IEC
    Dx CXR (Coeur en sabot / Oligemia)-ECG-ECHO

    Cardio Page 1
    Dx CXR (Coeur en sabot / Oligemia)-ECG-ECHO
    ttt Propranolol (Prevent spells)
    Spells ttt : Squatting + O2 + NaHCO3 + Inderal +
    Morphine
    Iron therapy
    Surgical : Pulmonary systemic anastomosis /
    Brock operation (infundibular) / Open heart
    surgery

    ASD :
    Etiology Defect in interatrial septum (ostium secundum /
    Primum / Sinus Venosus)
    Ostium secundum is more common and less
    serious
    Path. Lt to Rt shunt > Lung plethora > RVH
    C/P Usually Asymptomatic
    May Dyspnea/R chest infection/Exercise
    intolerance/Growth retardation
    Ex Wide fixed Splitting of S2
    Shunt produce No murmur (but can be in
    functional PS)
    if murmur it is ejection systolic
    Complications RVF / IEC / Eisenmenger / Lautenbacher
    syndrome (ASD + Rheumatic MS)
    Dx CXR-ECG-ECHO
    ttt Surgical : if large defect

    PDA :
    Etiology Persistence of ductus arteriosus just distal to left
    subclavian
    Aorta to pulmonary Shunt (systole and diastole)
    Lung Plethora > Lt side enlargement
    C/P Asymptomatic if small
    Recurrent chest infection
    Hyperdynamic circulation
    Ex Water hummer pulse
    Systolic thrill (Lt infraclavicular)
    Accentuated S2 (PHTN)
    Machinery continuous murmur at Lt
    infraclavicular area (appear after first week)
    propagate to pulmonary area
    Complications Selective Cyanosis- HF-IEC-Recurrent chest
    infections-PHTN-Eisenmenger -Failure to thrive
    Dx CXR (LV enlargement/Plethora)-ECG-ECHO
    ttt Medical : Indomethacin / ibuprofen /
    Paracetamol (initiate closure in preterm baby in
    1st week)
    Surgical : Closure surgery (before 1 yr.)

    Cardio Page 2
    Surgical : Closure surgery (before 1 yr.)

    Coarctation of the Aorta :


    Etiology Localize aorta narrowing (common just distal to Lt
    subclavian A origin)
    Inc. BP in Upper body part and dec. in the lower part
    Lt ventricle hypertrophy
    HTN in Upper limb
    Weak/Absent/Delay Femoral Pulse
    C/P If severe : Headache/Blurring of vision/early HF
    Ex Accentuated A2
    Systolic harsh murmur at Lt sternal border propagate
    to interscapular region
    Rib Notching (due to development of collaterals)
    Complicati HF/Intracranial Hemorrhage / IEC/HTN
    ons
    Dx CXR (LV enlargement/Rib Notching)-ECG-ECHO
    ttt Medical : Indomethacin / ibuprofen / Paracetamol
    (initiate closure in preterm baby in 1st week)
    Surgical : Closure surgery (before 1 yr.)

    Aortic stenosis Pulmonary stenosis


    Congenital stenosis Congenital stenosis
    (supra/Sub/Valvular) (supra/Sub/Valvular)
    Out flow obstruction > Lt Out flow obstruction > Rt
    ventricle hypertrophy ventricle hypertrophy
    Low COP (syncope/chest Cyanosis
    pain/dizziness/excursive duct dependent circulation
    intolerance)
    Small volume (Plate) Decrease S2
    low systolic BP Wide splitting
    Decrease S2 Harsh ejection systolic murmur
    May Paradoxical splitting at P propagate to infraclavicular
    Systolic Thrill at A1 are
    Systolic ejection click
    Harsh ejection systolic murmur at
    A1 propagated to neck
    LHF / IEC RHF / IEC
    Dx
    ttt If more 50mmg pressure Balloon Valvuloplasty/Valvotomy
    gradient :
    Balloon Valvuloplasty/Valvotomy

    TGA :
    Def Aorta arise from RV and Pulmonary from LV +
    2 Parallel circulations
    Essential Communication (VSD/ASD/PDA)

    Cardio Page 3
    Essential Communication (VSD/ASD/PDA)
    CP Deep central cyanosis
    Dyspnea / Recurrent chest infection
    HF manifestations
    Signs Central cyanosis/Clubbing/HF
    Lt parasternal pulsation (RVH)
    Accentuated S2
    No murmur (May murmur of VSD)
    Complications Polycythemia (Thrombosis) - Brain Abscess -
    Recurrent chest infections- HF and IEC
    Dx CBC (Inc. Hb)-CXR (Egg on side heart/Na / Plethora)-
    ECG-ECHO
    ttt Prostaglandin to maintain PDA
    Rashkin procedure (Urgent Shunt)(Balloon atrial
    septostomy)
    Total correction (within 2-3 week of life)(Atrial switch)

    Cardio Page 4

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