PANCE REVIEW: Congenital Heart Dz

According to the NCCPA site - the following congenital heart dz are fair game on the the PANCE. I have listed them with some key buzz words:

Red = non-cyanotic
Blue = cyanotic

Ventricular septal defect
-systolic murmur, LLSB
-sx are size dependent (range from asymptomatic to CHF)
-"Outlet VSD" - most common in Chinese and Japanese

Atrial septal defect
-2nd most common
-systolic ejection murmur, 2nd LICS
-failure to thrive
-RV heave
-wide fixed S2 split 
 (If you can remember ASD is #2 - then you can remember 2nd LICS and fixed S2 split!)

*septal defects are #1 and #2 most common 

Coarctation of the aorta
-systolic, LUSB (may be Continuous)
-infants may present with CHF
-older kids may present with systolic HTN +/- murmur

Patent ductus arteriosus (PDA)
-continuous machinery murmur (I remember it has a PDA- like a phone- is a machine.)
-Wide pulse pressure (machine = "wide" screen TV)
-hyperdynamic apical pulse

Tetralogy of fallot
-HOLOsystolic at LSB 
-cyanosis, clubbing
-increased RV impulse at LLB
-Loud S2
-Associated things: polycythemia vera + hypercyanotic spells (Med Emergency!)

Source: AAPA and PAEA Exam Review Book
Image: http://www.healthofchildren.com/C/Congenital-Heart-Disease.html

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