Peds Cardiology
1. what hx questions should you ask?: maternal hx to asses for RF detailed
fam hx
poor growth, feeding difficulties, fatigue/fussiness, cyanosis, SOB, palpitations, lh, syncope
2. what should you look at on exam?: Vitals
inspect for cyanosis, dysmorphic facial features
cardiac auscultation
palpation of pulses for symmetry
abdominal/extremity exam for evidence of fluid overload
3. what is part of a typical peds cardio work up?: EKG CXR
Echocardiogram** to assess cardiac structures lipid
profile
4. what is the congenital heart defect screening?: done in all states in US Pulse ox
after 24 hours of life
5. what is considered a positive congenital heart defect screening?: any of the following:
- SpO2 <90% in either extremity
- SpO2 <95% in BOTH right hand & lower extremity on 2-3 measurements (each separated
by 1 hr)
- SpO2 difference >4% between upper and lower extremities on 2-3 measurements (each
separated by 1 hr)
6. what is the MC innocent heart murmur of childhood?: still murmur
7. what causes the still murmur?: increased blood flow through pulmonary outflow tract
often seen in children 3-6 yo
8. how is still murmur treated?: none needed
9. what are features associated with innocent murmurs?: grade </=2 softer
when patient sitting than laying down
1/
, Peds Cardiology
short systolic duration
minimal/no radiation musical
or vibratory quality
10.what is acyanotic congenital heart disease?: left to right shunts resulting in an
increase in pulmonary blood flow
11.what are the acyanotic congenital heart diseases?: Ventricular septal defect
Atrial septal defect Patent
ductus arteriosus
2/
1. what hx questions should you ask?: maternal hx to asses for RF detailed
fam hx
poor growth, feeding difficulties, fatigue/fussiness, cyanosis, SOB, palpitations, lh, syncope
2. what should you look at on exam?: Vitals
inspect for cyanosis, dysmorphic facial features
cardiac auscultation
palpation of pulses for symmetry
abdominal/extremity exam for evidence of fluid overload
3. what is part of a typical peds cardio work up?: EKG CXR
Echocardiogram** to assess cardiac structures lipid
profile
4. what is the congenital heart defect screening?: done in all states in US Pulse ox
after 24 hours of life
5. what is considered a positive congenital heart defect screening?: any of the following:
- SpO2 <90% in either extremity
- SpO2 <95% in BOTH right hand & lower extremity on 2-3 measurements (each separated
by 1 hr)
- SpO2 difference >4% between upper and lower extremities on 2-3 measurements (each
separated by 1 hr)
6. what is the MC innocent heart murmur of childhood?: still murmur
7. what causes the still murmur?: increased blood flow through pulmonary outflow tract
often seen in children 3-6 yo
8. how is still murmur treated?: none needed
9. what are features associated with innocent murmurs?: grade </=2 softer
when patient sitting than laying down
1/
, Peds Cardiology
short systolic duration
minimal/no radiation musical
or vibratory quality
10.what is acyanotic congenital heart disease?: left to right shunts resulting in an
increase in pulmonary blood flow
11.what are the acyanotic congenital heart diseases?: Ventricular septal defect
Atrial septal defect Patent
ductus arteriosus
2/
