Since what age should patients be screened for HTN?
3 yo
Name 3 risk factors for congenital heart disease
Chromosomal Abnormalities
TORCH infections
Maternal Diabetes
Fetal Alcohol Syndrome
DiGeorge Syndrome
What is the diagnosis?

Mobitz Type 2 block
What is the diagnosis in a 12yo F who complains of palpitations? Cardiac exam shows a regular rate and rhythm with a mid-systolic click but no murmur.
Mitral Valve Prolapse
True or False?
Innocent heart murmurs are usually soft, systolic, nonradiating, and vibratory in nature, which increase in intensity when a patient is moved from supine to sitting.
False
*Soften in intensity when a patient is moved from supine to sitting.
Name 3 causes of Cardiac Syncope

Name 3 ductal dependent CHD
- CoA
- Transposition of the great vessels
- Left hypoplastic heart syndrome
- Severe aortic stenosis
- TOF with pulmonary atresia
- Interrupted aortic arch
What is the best next step for a 15 yo M with signs of cardiopulmonary compromise, palpable pulse and the following EKG?
Name 2 causes of aquired long QT syndrome
Electrolyte disturbances: Hypokalemia, hypocalcemia, and hypomagnesemia
Medications: macrolides, fluoroquinolones, antipsychotics, tricyclic antidepressants
What is the best next step for a 16 yo M who had a sudden loss of consciousness while exercising? EKG showed sinus tachycardia.
Echocardiography
At what ages should all children be screened for dyslipidemia?
Between the ages of 9 and 11 and again from 17 to 21.
An 8 yo M with hx of unrepaired VSD now presents with clubbing, exercise intolerance and failure to thrive. What is the reason for this presentation?
Eisenmenger Syndrome, where progressive shunting causes pulmonary hypertension
What is the first-line treatment for a 13 yo M with the student onset of palpitations? EKG shows a narrow complex tachycardia at 200bpm. Vital signs are normal and he is AAOx3.
Vagal maneuvers
The most commonly used maneuvers include ice to the face in infants, blowing into a blocked straw, Valsalva maneuver, and a headstand.
What is the best next step for a 16 yo F that complains of a fluttering in her chest and her heart beating very fast during the last 2 months? PE and EKG is normal.
Holter monitor
What is the most likely dx in a 7mo M with fever, tachycardia, tachypnea, and hepatomegaly? Pt starts to sweat and vomits when feeding.
Myocarditis causing CHF
What is the best next step for a 10 yo with an LDL level of 150mg/dL on routine screening?
Repeat levels in 2-12 weeks
True or False
PE in a pt with HCM will show a systolic murmur that increases in intensity with the valsava maneuver
True
What is the best next step in management for a 15 yo F with complaints of palpitations when she feels anxious, ill, or exercises? EKG is shown:
Echocardiography and Holter
(To rule out structural heart disease)
What is the first-line treatment for a post-operative cardiac patient presenting junctional ectopic tachycardia?
Amiodarone
Junctional ectopic tachycardia is due to abnormal automaticity either in the AV node or close to the AV node. This results in atrioventricular dissociation, which can ultimately result in low cardiac output syndrome with cardiogenic shock. EKG will demonstrate the AV dissociation, with no relation of the p-waves to the narrow QRS complexes.
What are the more common signs or symptoms in infants and children with heart failure?
GI symptoms such as feeding intolerance, vomiting, diaphoresis or sweting when eating
Which test would most likely establish the diagnosis in a 14 yo M presenting with episodic headaches, sweating, and tachycardia? He has lost weight in the last 6 months. BP is 185/90 mmHg.
Plasma fractionated metanephrines
Secondary causes of hypertension should be evaluated in cases of hypertensive emergencies. The classic triad of pheochromocytoma is episodic headaches, sweating, and tachycardia.
What is the dx of a neonate with cyanosis, unresponsive to oxygen and prostaglandin infusion. Chest x-ray shows a small cardiac silhouette with diffuse pulmonary edema.
Total Anomalous Pulmonary Edema
What is the dx in a 17 yo with syncope and the following EKG?

Junctional Rythm
Junctional rhythms are regular supraventricular rhythms in which the P wave in lead II is negative or absent.
Which is the best treatment for an 8 yo F with previous correction for CoA now presenting with hypertension in R arm but non-palpable femoral pulses?
Cardiac catheterization with balloon angioplasty
What is the most likely reason for a patient to go into cardiac arrest after a ball at high velocity hits his chest and he collapses and finds pulseless?
Ventricular Fibrillation
Commotio Cordis