| ASD 🫀 |
- Often asymptomatic in childhood
- Fatigue, exertional dyspnoea later
- Fixed split S2 ⭐
- Systolic ejection murmur (pulmonic area)
|
- Echo → definitive
- CXR → cardiomegaly, ↑ pulmonary markings
- ECG → RBBB, right axis deviation
|
- Small ASDs → may close spontaneously
- Device closure (transcatheter)
- Surgical closure if unsuitable
|
| VSD 🫀 |
- Holosystolic murmur (LLSB)
- Small → often asymptomatic
- Large → heart failure, FTT, recurrent chest infections
|
- Echo → size & site
- CXR → cardiomegaly, ↑ pulmonary flow
- ECG → LAE, LVH
|
- Small → observe
- Large → diuretics, ACEi, digoxin
- Surgical closure if symptomatic/large
|
| PDA 🔔 |
- Continuous “machine-like” murmur ⭐
- Wide pulse pressure
- Bounding pulses
- Large PDA → HF, resp distress
|
- Echo → flow through duct
- CXR → cardiomegaly, pulmonary plethora
- ECG → LAE in large PDA
|
- Indomethacin/Ibuprofen (preterm)
- Device closure or surgical ligation
- Monitor for endocarditis
|
| Coarctation of Aorta 🩸 |
- Upper limb hypertension
- Weak/delayed femoral pulses
- BP difference arms vs legs
- Systolic murmur (back/axilla)
|
- Echo → diagnosis
- CXR → rib notching, “3 sign” ⭐
- CT/MRI angiography
|
- Balloon angioplasty ± stent
- Surgical repair if severe
- Long-term follow-up → hypertension, restenosis
|
| Aortic Stenosis 🚪 |
- Systolic ejection murmur (RUSB)
- Severe → syncope, angina, dyspnoea
- Narrow pulse pressure
- LVH signs
|
- Echo → severity, LV function
- ECG → LVH, strain
- CXR → post-stenotic dilation
|
- Balloon valvuloplasty (symptomatic)
- Surgical AVR if severe
- Monitor for endocarditis
|
| Pulmonary Stenosis 💨 |
- Systolic ejection murmur (LUSB)
- RVH signs
- Exertional dyspnoea
- Severe → cyanosis
|
- Echo → RV function, stenosis severity
- ECG → RVH
- CXR → post-stenotic PA dilation
|
- Balloon valvuloplasty
- Surgical repair if refractory
- Long-term monitoring
|
