ENPC Cardiovascular Emergencies Flashcards

A 3-month-old presents with poor feeding, pallor, and mottling. The ECG shows a narrow complex tachycardia with HR of 235 bpm. What is the most likely diagnosis?

Answer: Supraventricular tachycardia (SVT)

SVT in infants typically presents with heart rates above 220 bpm, narrow QRS complexes, and signs of poor perfusion.

Initial management for a hemodynamically STABLE infant with SVT includes:

Answer: Vagal maneuvers such as ice bag application to the face

Vagal maneuvers are the first-line treatment for stable SVT in infants; the diving reflex stimulated by ice water bag application to the face is particularly effective.

What is the correct defibrillation energy dose sequence for pediatric ventricular fibrillation?

Answer: 2 J/kg initially, then 4 J/kg for subsequent shocks

PALS guidelines recommend 2 J/kg for the first defibrillation attempt and 4 J/kg for subsequent attempts in pediatric VF.

A 10-year-old collapses during soccer. He is unresponsive, pulseless, and a defibrillator is immediately available showing VF. What is the PRIORITY action?

Answer: Defibrillate immediately without delay

In witnessed pediatric cardiac arrest with an immediately available defibrillator and shockable rhythm, early defibrillation should not be delayed.

Which finding BEST differentiates cardiogenic shock from septic shock in a pediatric patient?

Answer: Hepatomegaly, gallop rhythm, and jugular venous distension

Hepatomegaly, gallop rhythm, and JVD are signs of cardiac failure and fluid overload, distinguishing cardiogenic from septic shock.

A 2-week-old previously healthy neonate presents with sudden cardiovascular collapse. Which diagnosis MUST be considered?

Answer: Duct-dependent congenital heart disease with spontaneous ductal closure

Duct-dependent congenital heart lesions can cause sudden cardiovascular collapse as the ductus arteriosus closes in the first weeks of life.