Doctors can study how best to recognize and treat congenital heart disease and heart murmurs with these printable medical flash cards.
There are 42 flash cards in this set (7 pages to print.)
To use:
1. Print out the cards.
2. Cut along the dashed lines.
3. Fold along the solid lines.
Sample flash cards in this set:
| Questions | Answers |
|---|---|
| Description of Congenital Heart Disease | Disease of the Cardiovascular system that occurs prenatally and becomes evident at birth, infancy, or young adulthood.Can be cyanotic or acyanotic |
| Risk Factors for Congenital Heart Disease | Family Hx Premature Birth Maternal exposure to alcohol, coxsackie B, cytomegalovirus, influenza, isotretioin, lithium, mumps, rubella, thalidomide, x-ray exposure during pregnancy, or other substances Associated with some chromosomal abnormalities Maternal age over 40 prenatal or perinatal fetal distress CHD in other siblings |
| Acyanotic Diseases of CHD | Atrial Septal Defect Atrioventricular Septal Defect Ventricular Septal Defect Patent Ductus Arteriosus |
| Cyanotic Disease of CHD | Transposition of the Great Vessels (Arteries) Tetrology of Fallot Tricuspid Atresia |
| Obstructive Diseases of CHD | Aortic Stenosis Pulmonic Stenosis Coarctation of the Aorta |
| Atrial Septal Defect | Mid-systolic Ejection Murmur Asymptomatic early in life Accentuation of tricuspid valve closure Wide Fixed S2 Arterial pulses = bilaterally Grade I-III/VI harsh murmur Easy fatigability Prone to respiratory infections May have delayed growth and development |
| Atrioventricular Septal Defect | Systolic and Mid-diastolic murmur Frequent respiratory infections Delayed growth and developement, poor weight gain Wide split S2 Usually diagnosed in first year of life; often associated with Trisomy 21 |
| Ventricular Septal Defect | Holosystolic murmur Frequent respiratory infections Easy fatigability Delayed growth and development; poor weight gain Chronic heart failure frequently present; S3 audible Grade II-VI/VI murmur depending on severity Palpable left sternal border thrill |
| Patent Ductus Arteriosus | Systolic and Diastolic murmur Poor weight gain Diaphoretic during feedings May present as soft, localized at left clavicle Murmur progresses to harsh, continuous, rumbling murmur Bounding pulses |
| Transposition of the Great Arteries | Systolic and Diastolic murmur Cyanotic Chronic heart failure Large for gestational age, but delayed growth and development |
| Tetralogy of Fallot | Systolic Ejection murmur Cyanotic Chronic heart failure "Tet" spells; cyanotic episodes precipitated by crying, feeding, and other activities Poor growth and development Squatting after exertion Easy fatigability Pale skin, poor turgor, clubbing Grade III-VI/VI harsh, murmur at 2nd ICS, left sternal border, with a thrill |
| Tricuspid Atresia | Holosystolic murmur Cyanotic Tachycardia Grade III-VI/VI harsh, murmur at left sternal border Poor growth, development, poor feeding, easy fatigability |
| Aortic Stenosis | Systolic Ejection murmur Grade III or IV/VI harsh murmur at upper right sternal border, rightneck, apex Weak peripheral pulses Easy fatigability Chronic Heart Failure |
| Pulmonic Stenosis | Mid to late Systolic Ejection murmur Cyanotic Chronic Heart Failure Grade III-IV/VI harsh, murmur heard at upper left sternal border, transmission into both lungs, left neck |
| Coarctation of the Aorta | Systolic murmur Decreased blood pressure in lower extremities (upper extremity hypertension, lower extremity hypotension) Diminished pulses in lower extremities compared to upper extremities |
| Diagnostic Studies for Congenital Heart Disease | Chest X-ray Electrocardiogram Echocardiogram Arterial blood gas Angiographic studies |
| Non-Pharmacologic Management of Congenital Heart Disease | Depends on severity Activity restriction Surgical repair Patient education |
| Pharmacologic Management of Congenital Heart Disease | PDA: Indomethacin helps consricts and close PDA TGA: Prostaglandin E1 to delay closure of the ductus until surgery |
| Follow-Up for CHD | Depends on severity, age, and type of defect Careful attention to murmur at each visit; Consider referral to pediatric cardiologist for changes in murmur |
| Etiologies of Heart Murmurs | Organic: Due to cardiovascular disease Functional: Disturbances produced within the cardiovascular system but which are due to other causes (ex. anemia, thyrotoxicosis, pregnancy) Innocent Murmurs: Disturbances which may or may not be cardiac in origin, but no cardiac disease is recognized as the cause |
| Assessing Heart Murmurs | Timing: Systolic or Diastolic, position in systole or diastole (early, mid, late, pan) Site: Point of maximal intensity, point of propagation Loudness: Grading Quality: Blowing, Harsh, Musical, Soft Shape: Decrescendo, Crescendo, Plateau, Diamond |
| Grading of Murmurs | Grade 1: Barely audible with intense concentration Grade 2: Faint, but audible immediately Grade 3: Moderately loud, no thrill palpable Grade 4: Loud with a palpable thrill Grade 5: Very loud, audible with part of the stethoscope off the chest, thrill palpable Grade 6: Audible without a stethoscope on the chest wall, thrill palpable |
| Innocent Murmurs (Still's, Venous Hum, Systolic Ejection) | Most frequently detected in children and adolescents Soft, short, systolic, no other evidence of abnormality May be musical or vibratory Able to alter by maneuvers (standing, lying, posture change...) Varies in loudness from visit to visit Does not affect growth and development Left lower sternal border or pulmonic area are most common sites Normal S1 and S2, normal vitals |
| Types of Systolic Murmurs | Aortic Stenosis Hypertrophic Obstructive Cardiomyopathy Pulmonic Stenosis Mitral Valve Insufficiency Tricuspid Regurgitation Ventricular Septal Defect |
| Aortic Stenosis Murmur | Systolic Ejection (Mid systole) Most frequently heard in elderly pts Heard best in 2nd ICS to the right of the sternum Sound radiates to right clavicle and transmitted to both carotid arteries Systolic thrill may be present |
| Hypertrophic Obstructive Cardiomyopathy | Late systolic Best heard at the lower left sternal border Increases with Valsalva maneuver, standing Crescendo/ Decrescendo murmur Usually does not radiate to neck, but biphasic carotid pulse |
| Pulmonic Stenosis Murmur | Mid Systolic Murmur Heard best at 2nd ICS left sternal border Does not radiate like aortic murmur Variable click audible |
| Mitral Valve Insufficiency | Systolic murmur Mitral valve prolapse may not produce murmurs(mid to late systolic cycle) Mitral regurgitation is holosystolic Best heard at apex of heart with pt in left lateral decubitus position Radiates toward left axilla Varies in intensity |
| Tricuspid Regurgitation | Systolic murmur Best heard at left lower sternal border, over the xiphoid, sometimes over the liver Increases in intensity with inspiration Regurgitant "v" waves in the neck veins |
| Ventricular Septal Defect | Holosystolic murmur Best heard at left sternal border, 4th ICS Often harsh The greater the gradient, the louder the murmur |
| Diastolic Murmurs | Always considered abnormal Tend to be softer than systolic murmurs Best heard with bell of stethoscope because of low pitch |
| Types of Diastolic Murmurs | Mitral Stenosis Tricuspid Stenosis Aortic Regurgitation Pulmonic Regurgitation |
| Mitral Stenosis | Mid-Diastolic murmur Low-pitched apical murmur Best heard after mild exercise and pt in left lateral decubitus position May be isolated to the apex beat site Does not radiate |
| Tricuspid Stenosis | Early Diastolic Murmur Best heard in the 4th or 5th ICS left of the sternum, xiphoid, or apex Increased in duration and intensity by exercise, inspiration, sitting forward Decrescendo murmur |
| Aortic Regurgitation | Early Diastolic Murmur Blowing, high-pitched, decrescendo murmur Best heard at left sternal border and toward the apex |
| Pulmonic Regurgitation | Diastolic Murmur High-pitched decrescendo murmur Radiates to apex Heard loudest at 2nd ICS at sternal border |
| Types of Continuous Murmurs | Patent Ductus Ateriosus Coarctation of the Aorta |
| Patent Ductus Arteriosus | Heard throughout systole and diastole Bounding pulses |
| Coarctation of the Aorta | Heard throughout systole and diastole Weak femoral pulses |
| Diagnostic Studies for Murmurs | Electrocardiogram Chest x-ray Doppler echocardiography Angiography |
| Nonpharmacologic Management of Heart Murmurs | Surgical Repair (palliative) Pt education |
| Consultation/Referral for Heart Murmurs | Refer all new, non-innocent murmurs to cardiologist |
