Pediatrics Recalls By Subject – Cardiology

A 16-year-old boy presents with 2 weeks of chest pain, lateral to the lower sternal border. The pain is worsened by movement and position changing, and not accompanied by shortness of breath or affected by strain.

Which of the following is a possible treatment for his condition?

A 3-month-old baby presents with severe restlessness with no additional symptoms. Examination reveals an afebrile infant, with normal oxygen saturation in room air, heart rate of 240/min, blood pressure of 80/40. The rest of the physical examination is normal.

Which of the following will contribute the most to diagnosis?

A 2-hour-old newborn is evaluated for central cyanosis. Oxygen saturation in room air is 60%, heart rate is 160 per minute, breath sounds are good and equal, and there is no murmur. Hyperoxia test revealed low PaO2.

Which of the following describes the next step in this newborn’s care?

A 5-day-old male, referred to the emergency room due to a seizure that stopped after the administration of Dormicum (Midazolam). On examination – no fever, alert, normotensive fontanel, cleft palate and small ears, systolic murmur on auscultation to the heart. On initial laboratory tests ionized calcium 0.6 (low). An echocardiogram demonstrated a Truncus Arteriosus type defect. Which test is highly likely to identify the underlying genetic disorder in the baby’s diagnosis?

A 7-year-old boy, normally healthy, underwent an ECG as part of screenings for a football team (attached).

What is the type of arrhythmia?

A 15-year-old boy is referred for evaluation due to a drop in his academic achievements and new complaints of anxiety and depression. Blood tests demonstrate increased levels of liver enzymes and hemolytic anemia. An eye examination revealed the attached finding (in the image).

What blood test finding is highly likely to support the diagnosis?

An 8-year-old boy arrives at the emergency department due to restlessness, hyperventilation, and loss of appetite which appeared several hours before his admission. On examination: pulse 280 per minute, temperature 37.3°C, BP 60/35 mmHg, 70 breaths per minute.

What is the most recommended treatment in this case?

During the examination of a one-month-old infant, a murmur was heard. Blood oxygen saturation at rest is around 80% in room air, without improvement after oxygen administration.

Which of the following etiologies could explain his condition?

A 12-year-old boy presents with fatigue and malaise that have recently become worse, followed by dyspnea.

His mother reports episodes of cyanosis following light physical activity. He has been followed up by a cardiologist due to a VSD until 2 years of age, and the follow up was discontinued since they moved. Chest X-ray demonstrates an enlarged heart

silhouette, and enlargement of the pulmonary artery.

Which of the following is the most appropriate treatment for this patient?

Which of the following patients is suspected of being immunodeficient?

A 3-months-old infant presents with stridor, episodes of spitting up and vomiting, with arching of the back and neck. The mother reports the stridor is improved while arching. Thickening of the feeds was unhelpful.

Which of the following tests is most appropriate for the most likely diagnosis?

A 6-year-old girl with a history of Fontan operation presents with episodes of tachycardia and separate episodes of presyncope with dizziness and weakness.

Which of the following is the most appropriate treatment?

Which of the following is an absolute contraindication for physical activity?

An 18-month-old infant presents with fever, malaise, dyspnea, tachycardia, and hypotension.
Examination reveals a heart murmur with gallop heart rate. Echocardiography demonstrates
reduced ventricular function, dilated ventricles, and mitral insufficiency. Blood work includes increased troponin and PBNP levels.
Which of the following is the most common etiology?

A 13-year-old boy had a loss of consciousness episode during a football game.
Workup included the attached ECG strip, after which beta blocker treatment was initiated.

A few months later he has had an additional episode of loss of consciousness.
Which of the following is the most appropriate treatment?

A 2-day-old newborn in the nursery presents with cyanosis, room air oxygen saturation of 70%, and auscultation reveals a single second heart sound (S2), with no murmurs.

Which of the following is the most likely diagnosis?

In which of the following conditions administration of 100% oxygen during an hyperoxic test will increase the saturation from 72% to 79%?

A 7-year-old deaf boy presents with several episodes of syncope during exertion. ECG is below.

Which of the following is the most appropriate treatment?

A term newborn exhibits profound cyanosis shortly after birth. Echocardiograph reveals the aorta attached to the right ventricle, and the pulmonary artery to the left ventricle.

Which of the following is the most appropriate initial treatment?

A 4-months-old baby presents with cyanosis and shortness of breath, alleviated in the knee to chest position. Chest X-ray recalls a boot shape heart silhouette (“Coeur en sabot”). ECG reveals a right axis and signs of right ventricular hypertrophy.

Which of the flowing is the most likely diagnosis?

A 1-year-old boy presents with weakness and apathy for an hour. On admission he is pale, grunting, and with a weak cry. His heart rate is 245 bpm, saturation is 97% with an oxygen mask. Capillary fill is 7 seconds and blood pressure is unmeasurable on several attempts.
A picture from the monitor is attached.

Which of the following is the next step in managing this patient?

A 15-year-old boy complains of pain and weakness in his legs after running. On cardiac examination, a systolic murmur is auscultated, radiating to the back, and weak femoral pulses are palpated. What additional symptom will most likely accompany his illness?

A 16-year-old male referred to the ER due to increase in temperature, cough, stabbing chest pain that are exacerbated during inspirium and relieved by sitting. On auscultation, distant heart sounds and pericardial friction rub heard. X-ray image below.

What is most likely to be found in an ECG in this case?

A two-month-old male presented in the ER following a fever and a cough. On examination, he has a cleft palate. A chest x-ray demonstrated opacity at the base of the left lung and the absence of the thymus. Which of the following laboratory tests would advance the presumed diagnosis?

The 4-year-old child in the picture is developmentally delayed. Examination reveals an early systolic ejection click, and he has

hypercalcemia, failure to thrive, and hypothyroidism.

Which of the following is the boys’ most probable heart defect?

A 5-months-old infant presents with respiratory distress especially during feeds, stridor, and dysphagia with arching of the back during swallowing. Echocardiography reveals right aortic arch.

Which of the following is the most appropriate treatment?

A 13-year-old boy is hospitalized due to prolonged fever, weakness, and myalgia. The physical examination reveals a new murmur on auscultation to the heart and an enlarged spleen is palpated. Later, lesions appeared as seen in the attached images. Blood cultures positive.

What is the common pathogen that causes this condition?

A 15-year-old girl suffering from Turner syndrome with bicuspid aortic valve complains of pain after exertion in both legs. Chest x-ray and ECG demonstrate signs consistent with left ventricular hypertrophy. Femoral pulse is not palpable.
Which of the following signs would most likely support the etiology for her condition?

A 4-year-old male presents two weeks after a viral upper respiratory tract infection. On examination, he was afebrile, respiratory rate of 40 breaths/min, an irregular heartbeat with gallop rhythm, systolic murmur (2/6) at the heart apex, and hepatomegaly in the abdominal examination. Apart from that, the examination was unremarkable.
What is the most likely diagnosis?

In which of the following diagnoses can the phenomenon presented in the picture be observed?

A 16-year-old male has blood pressure of 160/70 in the right arm. The following measurements were obtained from a cardiac catheterization:

Based on these data, what is the structural cardiac defect in this teenager?

A 15-year-old boy complains of pain and weakness in his legs after running. During the cardiac examination, a short systolic murmur is heard at the border of the middle sternum and between the shoulder blades, and the chest X-ray demonstrates NOTCHING at the lower border of the ribs.

In accordance with these findings, what is the most likely finding that will accompany his complaints?

Male, 8 months of age, referred to the ER due to restlessness, tachypnea, and a decrease in appetite that appeared around a day before his admission. Upon examination, pulse of 280 per minute, temperature 37.3°C, BP 60/35 mmHg, 70 breaths per minute. An attempt to open a vein and provide an intraosseous infusion failed.

The following finding was observed on the monitor

What is the most appropriate treatment for his condition?

Male, 4 years of age, suffering from dyspnea after mild exertion that improves after squatting. Which of the following diagnoses is most likely in this case?

As part of a routine examination, in cardiac auscultation of a 4-month-old boy, a gentle 2/6 systolic murmur was heard, and widely split and fixed S2. Normal oxygen saturation. A chest X-ray demonstrated enlargement of the right atrium and ventricle.

What is the likely etiology?

An ECG was performed on a newborn with the attached results.

What anamnestic detail can explain the findings seen on the ECG?