Pediatric CCRN Cardiovascular Flashcards

Which chest X-ray finding is MOST characteristic of total anomalous pulmonary venous return (TAPVR) with obstruction in a neonate?

Answer: Ground-glass opacification with white-out pattern

Obstructed TAPVR causes severe pulmonary venous hypertension and edema, producing a ground-glass or white-out appearance on CXR due to pulmonary edema.

A child with aortic stenosis has a peak-to-peak gradient of 75 mmHg on cardiac catheterization. This finding indicates:

Answer: Severe aortic stenosis requiring intervention

A peak-to-peak gradient ≥70 mmHg across the aortic valve is classified as severe aortic stenosis and typically warrants balloon valvuloplasty or surgical intervention.

What is the MOST common cause of acquired heart disease in children in the United States?

Answer: Kawasaki disease

Kawasaki disease is the leading cause of acquired pediatric heart disease in the US, primarily affecting the coronary arteries and potentially causing aneurysms if untreated.

A neonate with d-Transposition of the Great Arteries is critically cyanotic. Which medication maintains ductal patency until surgical repair?

Answer: Prostaglandin E1 (alprostadil)

Prostaglandin E1 (alprostadil) keeps the ductus arteriosus open, allowing mixing of oxygenated and deoxygenated blood to sustain the neonate until arterial switch operation.

Which finding on echocardiogram is DIAGNOSTIC of cardiac tamponade?

Answer: Right ventricular diastolic collapse

Right ventricular free wall collapse during diastole is the echocardiographic hallmark of cardiac tamponade, indicating pericardial pressure exceeds right-sided filling pressure.

A 5-year-old with known coarctation of the aorta presents with headache and elevated blood pressure in the arms. What is the EXPECTED finding in the legs?

Answer: Lower blood pressure than the arms

Coarctation of the aorta causes a blood pressure gradient with higher pressures proximal to the obstruction (arms) and lower pressures distal to it (legs).