Systolic
Pansystolic
LLSB: VSD, TR
APEX: MR due to RHD, MVP
Ejection systolic:
URSB: AS
ULSB: PS, ASD, ToF, CoA
Continous:
PDA: second left intercostal
Diastolic
Aortic regurgitation:
Pulmonic regurgitation: ULSB
Heart failure in young children : mid diastolic rumble
Investigations for cardiac
1) pulse oximetry
If the oxygen saturation is 95% and above then its most likely an acyanotic cardic pathology but if oxygen saturation is less than 95% then its a cyanotic cardiac pathology
2) hypoxia test
- pO2 has to be measured then 100% oxygen given to the patient if pO2 is less than 150 mmHg then its a problem of the heart but if it is greater then its a lung problem
Investigations for cardiac 2
3) ECG
4) Chest xray
Increased lung markings: VSD, ASD left to right shunt
Decreased lung markings: ToF, PS
Right to left shunt
5) Echocardiography
Investigations for cardiac 3
6) CT and MRI
7) angiography
Heart Failure
- Tetralogy of Fallot does not cause HF
- Supraventricular tachycardia can also cause HF
- when your heart is failing yhe body takes it that you are hypovolemic gence activates the RAAS system
- 4 main signs for heart failure: tachycardia, tachypnea, cardiomegaly and hepatomegaly
Heart failure 2
Drugs:
- diuretics: lasix, spironolactone
- ACEI/ARBs: enapril, lisinopril
- beta blockers: propanolol
Non medical:
Treat underlying cause via surgery
Atrial septal defect
- acyanotic CHD
- second most common CHD
- left to right shunt
- difference in pressure between the right heart snd left hesr is two hence there is no pressure overload
- eisenmenger not seen in ASD
https: //www.mayoclinic.org/diseases-conditions/ei
Atrial septal defect 2
- assymptomayic and gave slender bodies
- auscultation:
- widely fixed split second heart sound
- 2/6 TO 3/6 ejection systolic murmur ULSB
- many are almost silent
