A top podcast for healthcare leaders, with over one million downloads, Radio Advisory is your weekly download on how to untangle the industry's most pressing challenges to help leaders like you make the best business decisions for your organization. From unpacking major trends in care delivery—like site-of-care shifts and the rise of high-cost drugs—to demystifying stakeholder dynamics, to shining a spotlight on priorities that may get overlooked, we're here to help. Our hosts and seasoned r ...
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Heart Murmurs Part 2-Congenital Heart Disease
MP3•Trang chủ episode
Manage episode 205463047 series 2108787
Nội dung được cung cấp bởi PA Study Sesh. Tất cả nội dung podcast bao gồm các tập, đồ họa và mô tả podcast đều được PA Study Sesh hoặc đối tác nền tảng podcast của họ tải lên và cung cấp trực tiếp. Nếu bạn cho rằng ai đó đang sử dụng tác phẩm có bản quyền của bạn mà không có sự cho phép của bạn, bạn có thể làm theo quy trình được nêu ở đây https://vi.player.fm/legal.
Heart murmurs continue with congenital heart diseases.
A Picmonic is available for EVERY topic in today’s episode. Start by checking out our first topic here.
Ventricular Septal Defect
* #1 type of congenital heart disease
* Loud, high-pitched harsh, holosystolic murmur at LLSB
* Typically a left to right shunt (restrictive)
* May switch to right to left 2/2 pulmonary HTN (non-restrictive)
* “Eisenmenger’s syndrome”
* Dx: echocardiogram
* Tx:
* Observe if small
* Most close by age 10
* Surgery
* Symptomatic
* CHF
* Growth Delay
* Large VSDs repaired by age 2
Atrial Septal Defect
* Ostium secundum fails to close
* Often asymptomatic until >30y.o.
* Systolic ejection crescendo-decrescendo flow murmur @ pulmonic area (Left sternal border)
* Mimics pulmonic stenosis
* Widely split, fixed s2
* Does not vary with inspiration
* It’s not on either side of the heart
* Surgery if symptomatic
Coarctation of the aorta
* Narrowing of descending thoracic aorta
* Males>females
* 70% also have bicuspid aortic valve
* Symptoms
* Systolic murmur that radiates to the back/scapula/chest
* HTN (secondary)
* BP upper>lower extremities
* Delayed/weak femoral pulses
* Diagnosis
* Angiogram=gold standard
* CXR:
* Rib notching
* Increased flow in intercostal aa.
* 3 sign
* Narrowed aorta looks like the notch of a 3
* Tx: surgical
Patent Ductus Arteriosus (PDA)
* Connection between descending thoracic aorta & pulmonary artery
* Continuous, machinery murmur loudest @ pulmonic area
* Wide pulse pressure, bounding peripheral pulses
* Dx: echocardiogram
* Tx: indomethacin
* Inhibits prostaglandin production=closes PDA
Hypertrophic Cardiomyopathy
* Subaortic outflow obstruction secondary to hypertrophied septum
* Harsh, systolic, crescendo-decrescendo murmur at LLSB (similar to AS)
* DECREASES with INCREASED venous return
* Squatting, lying supine, etc
* Increased blood pushes septum out of the way
* INCREASES WITH DECREASED VENOUS RETURN
* Valsalva/standing
* Symptoms:
* Dyspnea usually 1st
* Chest pain
* Sudden cardiac death
* Especially during extreme exertion
* Secondary to v fib.
* Dx: echocardiogram
* Management:
* Avoid dehydration & extreme exertion
* B blockers 1st line medical
* Increases diastolic filling time
* Caution with digoxin, nitrates, and diuretics
* Surgical: myomectomy or alcohol septal ablation
Tetralogy of Fallot
* #1 cyanotic congenital heart disease
* Definition
* RV hypertrophy
* Rv outflow obstruction
* Pulmonary artery stenosis
* Overriding aorta
* VSD
* Right to left shunt=cyanotic
* “tet spells”
* Episodes of cyanosis
* Relieved by squatting
* Harsh,
…
continue reading
A Picmonic is available for EVERY topic in today’s episode. Start by checking out our first topic here.
Ventricular Septal Defect
* #1 type of congenital heart disease
* Loud, high-pitched harsh, holosystolic murmur at LLSB
* Typically a left to right shunt (restrictive)
* May switch to right to left 2/2 pulmonary HTN (non-restrictive)
* “Eisenmenger’s syndrome”
* Dx: echocardiogram
* Tx:
* Observe if small
* Most close by age 10
* Surgery
* Symptomatic
* CHF
* Growth Delay
* Large VSDs repaired by age 2
Atrial Septal Defect
* Ostium secundum fails to close
* Often asymptomatic until >30y.o.
* Systolic ejection crescendo-decrescendo flow murmur @ pulmonic area (Left sternal border)
* Mimics pulmonic stenosis
* Widely split, fixed s2
* Does not vary with inspiration
* It’s not on either side of the heart
* Surgery if symptomatic
Coarctation of the aorta
* Narrowing of descending thoracic aorta
* Males>females
* 70% also have bicuspid aortic valve
* Symptoms
* Systolic murmur that radiates to the back/scapula/chest
* HTN (secondary)
* BP upper>lower extremities
* Delayed/weak femoral pulses
* Diagnosis
* Angiogram=gold standard
* CXR:
* Rib notching
* Increased flow in intercostal aa.
* 3 sign
* Narrowed aorta looks like the notch of a 3
* Tx: surgical
Patent Ductus Arteriosus (PDA)
* Connection between descending thoracic aorta & pulmonary artery
* Continuous, machinery murmur loudest @ pulmonic area
* Wide pulse pressure, bounding peripheral pulses
* Dx: echocardiogram
* Tx: indomethacin
* Inhibits prostaglandin production=closes PDA
Hypertrophic Cardiomyopathy
* Subaortic outflow obstruction secondary to hypertrophied septum
* Harsh, systolic, crescendo-decrescendo murmur at LLSB (similar to AS)
* DECREASES with INCREASED venous return
* Squatting, lying supine, etc
* Increased blood pushes septum out of the way
* INCREASES WITH DECREASED VENOUS RETURN
* Valsalva/standing
* Symptoms:
* Dyspnea usually 1st
* Chest pain
* Sudden cardiac death
* Especially during extreme exertion
* Secondary to v fib.
* Dx: echocardiogram
* Management:
* Avoid dehydration & extreme exertion
* B blockers 1st line medical
* Increases diastolic filling time
* Caution with digoxin, nitrates, and diuretics
* Surgical: myomectomy or alcohol septal ablation
Tetralogy of Fallot
* #1 cyanotic congenital heart disease
* Definition
* RV hypertrophy
* Rv outflow obstruction
* Pulmonary artery stenosis
* Overriding aorta
* VSD
* Right to left shunt=cyanotic
* “tet spells”
* Episodes of cyanosis
* Relieved by squatting
* Harsh,
22 tập
MP3•Trang chủ episode
Manage episode 205463047 series 2108787
Nội dung được cung cấp bởi PA Study Sesh. Tất cả nội dung podcast bao gồm các tập, đồ họa và mô tả podcast đều được PA Study Sesh hoặc đối tác nền tảng podcast của họ tải lên và cung cấp trực tiếp. Nếu bạn cho rằng ai đó đang sử dụng tác phẩm có bản quyền của bạn mà không có sự cho phép của bạn, bạn có thể làm theo quy trình được nêu ở đây https://vi.player.fm/legal.
Heart murmurs continue with congenital heart diseases.
A Picmonic is available for EVERY topic in today’s episode. Start by checking out our first topic here.
Ventricular Septal Defect
* #1 type of congenital heart disease
* Loud, high-pitched harsh, holosystolic murmur at LLSB
* Typically a left to right shunt (restrictive)
* May switch to right to left 2/2 pulmonary HTN (non-restrictive)
* “Eisenmenger’s syndrome”
* Dx: echocardiogram
* Tx:
* Observe if small
* Most close by age 10
* Surgery
* Symptomatic
* CHF
* Growth Delay
* Large VSDs repaired by age 2
Atrial Septal Defect
* Ostium secundum fails to close
* Often asymptomatic until >30y.o.
* Systolic ejection crescendo-decrescendo flow murmur @ pulmonic area (Left sternal border)
* Mimics pulmonic stenosis
* Widely split, fixed s2
* Does not vary with inspiration
* It’s not on either side of the heart
* Surgery if symptomatic
Coarctation of the aorta
* Narrowing of descending thoracic aorta
* Males>females
* 70% also have bicuspid aortic valve
* Symptoms
* Systolic murmur that radiates to the back/scapula/chest
* HTN (secondary)
* BP upper>lower extremities
* Delayed/weak femoral pulses
* Diagnosis
* Angiogram=gold standard
* CXR:
* Rib notching
* Increased flow in intercostal aa.
* 3 sign
* Narrowed aorta looks like the notch of a 3
* Tx: surgical
Patent Ductus Arteriosus (PDA)
* Connection between descending thoracic aorta & pulmonary artery
* Continuous, machinery murmur loudest @ pulmonic area
* Wide pulse pressure, bounding peripheral pulses
* Dx: echocardiogram
* Tx: indomethacin
* Inhibits prostaglandin production=closes PDA
Hypertrophic Cardiomyopathy
* Subaortic outflow obstruction secondary to hypertrophied septum
* Harsh, systolic, crescendo-decrescendo murmur at LLSB (similar to AS)
* DECREASES with INCREASED venous return
* Squatting, lying supine, etc
* Increased blood pushes septum out of the way
* INCREASES WITH DECREASED VENOUS RETURN
* Valsalva/standing
* Symptoms:
* Dyspnea usually 1st
* Chest pain
* Sudden cardiac death
* Especially during extreme exertion
* Secondary to v fib.
* Dx: echocardiogram
* Management:
* Avoid dehydration & extreme exertion
* B blockers 1st line medical
* Increases diastolic filling time
* Caution with digoxin, nitrates, and diuretics
* Surgical: myomectomy or alcohol septal ablation
Tetralogy of Fallot
* #1 cyanotic congenital heart disease
* Definition
* RV hypertrophy
* Rv outflow obstruction
* Pulmonary artery stenosis
* Overriding aorta
* VSD
* Right to left shunt=cyanotic
* “tet spells”
* Episodes of cyanosis
* Relieved by squatting
* Harsh,
…
continue reading
A Picmonic is available for EVERY topic in today’s episode. Start by checking out our first topic here.
Ventricular Septal Defect
* #1 type of congenital heart disease
* Loud, high-pitched harsh, holosystolic murmur at LLSB
* Typically a left to right shunt (restrictive)
* May switch to right to left 2/2 pulmonary HTN (non-restrictive)
* “Eisenmenger’s syndrome”
* Dx: echocardiogram
* Tx:
* Observe if small
* Most close by age 10
* Surgery
* Symptomatic
* CHF
* Growth Delay
* Large VSDs repaired by age 2
Atrial Septal Defect
* Ostium secundum fails to close
* Often asymptomatic until >30y.o.
* Systolic ejection crescendo-decrescendo flow murmur @ pulmonic area (Left sternal border)
* Mimics pulmonic stenosis
* Widely split, fixed s2
* Does not vary with inspiration
* It’s not on either side of the heart
* Surgery if symptomatic
Coarctation of the aorta
* Narrowing of descending thoracic aorta
* Males>females
* 70% also have bicuspid aortic valve
* Symptoms
* Systolic murmur that radiates to the back/scapula/chest
* HTN (secondary)
* BP upper>lower extremities
* Delayed/weak femoral pulses
* Diagnosis
* Angiogram=gold standard
* CXR:
* Rib notching
* Increased flow in intercostal aa.
* 3 sign
* Narrowed aorta looks like the notch of a 3
* Tx: surgical
Patent Ductus Arteriosus (PDA)
* Connection between descending thoracic aorta & pulmonary artery
* Continuous, machinery murmur loudest @ pulmonic area
* Wide pulse pressure, bounding peripheral pulses
* Dx: echocardiogram
* Tx: indomethacin
* Inhibits prostaglandin production=closes PDA
Hypertrophic Cardiomyopathy
* Subaortic outflow obstruction secondary to hypertrophied septum
* Harsh, systolic, crescendo-decrescendo murmur at LLSB (similar to AS)
* DECREASES with INCREASED venous return
* Squatting, lying supine, etc
* Increased blood pushes septum out of the way
* INCREASES WITH DECREASED VENOUS RETURN
* Valsalva/standing
* Symptoms:
* Dyspnea usually 1st
* Chest pain
* Sudden cardiac death
* Especially during extreme exertion
* Secondary to v fib.
* Dx: echocardiogram
* Management:
* Avoid dehydration & extreme exertion
* B blockers 1st line medical
* Increases diastolic filling time
* Caution with digoxin, nitrates, and diuretics
* Surgical: myomectomy or alcohol septal ablation
Tetralogy of Fallot
* #1 cyanotic congenital heart disease
* Definition
* RV hypertrophy
* Rv outflow obstruction
* Pulmonary artery stenosis
* Overriding aorta
* VSD
* Right to left shunt=cyanotic
* “tet spells”
* Episodes of cyanosis
* Relieved by squatting
* Harsh,
22 tập
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