Findings: septal hypertrophy, pulmonary stenosis, diminished by hand grip maneuver, increases with standing or Valsalva, decreases with squatting
Notes: More likely in Noonan syndrome patients and infant of diabetic mothers.
Question: Which disease is associated with these findings?
Kawasaki Disease
Category: generalpediatrics-Cardiology 2
Findings: erythema or edema of hands, non-exudative conjunctivitis, polymorphic rash, unilateral cervical lymphadenopathy, strawberry tongue
Notes: In addition to fever for 5 days, must have 4 out of the above 5 findings. Supportive data include elevated ESR, thrombocytosis, and leukocytosis. Complications include coronary aneurysms, sterile pyuria, and liver dysfunction. Get echocardiogram and repeat in 2 and 6 weeks. Treat with high dose aspirin and IVIG, then regular aspirin for 6 weeks.
Question: Which disease is associated with these findings?
Notes: Treat with alpha blockers before resecting.
Precordial Catch Syndrome
Category: generalpediatrics-Cardiology 2
Findings: left-sided chest pain at rest that increases with inspiration, resolves without intervention
Prostaglandin (PGE)
Category: generalpediatrics-Cardiology 2
Findings: congestive heart failure in neonate due to coarctation of the aorta
Notes: There should be a differential between the right arm (preductal) and right leg (postductal) blood pressures.
Question: What do you use to treat the following condition?
Spironolactone
Category: generalpediatrics-Cardiology 2
Findings: diuretic, hyperkalemia, gynecomastia
Question: Which drug is associated with these findings?
Staphylococcus Aureus
Category: generalpediatrics-Cardiology 2
Findings: most common cause of acute bacterial endocarditis
Streptococcus Viridans
Category: generalpediatrics-Cardiology 2
Findings: most common cause of subacute endocarditis
Notes: May affect aortic valves the most.
SVC Syndrome
Category: generalpediatrics-Cardiology 2
Findings: night sweats, facial swelling, dusky skin, normal oxygen saturations, often caused by malignancy
Notes: Treated with radiation, steroids, and anti-cancer agents.
Tetralogy Of Fallot
Category: generalpediatrics-Cardiology 2
Findings: pulmonary stenosis, VSD, overriding aorta, right ventricular hypertrophy
Notes: Has a harsh LUSB murmur. Pulmonary stenosis causes right to left shunt and systolic murmur. No pulmonary HTN leads to clear CXR. Squatting or bringing knees up to increase systemic vascular resistance decreases shunting. Murmur is mostly from pulmonary stenosis and decreases with TET spell as flow through pulmonary valve lessens.
Question: What fits these findings?
Total Anomalous Pulmonary Venous Return (TAPVR)
Category: generalpediatrics-Cardiology 2
Findings: pulmonary congestion on CXR, requires PFO or ASD for life
Notes: Snowman-shaped heart.
Transposition Of The Great Arteries
Category: generalpediatrics-Cardiology 2
Findings: egg shaped heart, survival requires ASD for mixing, give PGE to keep PDA open, no murmur, cyanosis within hours
Tricuspid Atresia
Category: generalpediatrics-Cardiology 2
Findings: requires PDA, EKG showing LVH and LAD, cyanosis
Notes: Requires prostaglandin to keep PDA open.
Tricuspid Atresia
Category: generalpediatrics-Cardiology 2
Findings: left axis deviation, LVH, cyanosis, diminished pulmonary vascular congestion
Notes: TOF and TGA have RVH and cyanosis.
Truncus Arteriosus
Category: generalpediatrics-Cardiology 2
Findings: biventricular hypertrophy on EKG, cardiomegaly, associated with DiGeorge syndrome, causes severe congestive heart failure
Notes: Death commonly before age of one due to CHF.
Ventricular Septal Defect (VSD)
Category: generalpediatrics-Cardiology 2
Findings: high pitched holosystolic murmur at LLSB, neonate breathing harder, palpable thrill