Knowledge Check: Clinical Presentation of Congenital Heart Disease in the First Week of Life – Arrhythmias
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Question 1 of 8
1. Question
Which of the following is NOT an example of an irregular heart rhythm?
Hint
Premature contractions, originating either in the atria or the ventricles, cause the heart rate to be irregular.
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Question 2 of 8
2. Question
What is one possible reason why newborns with structurally normal hearts can have irregular heart beats?
Hint
Premature atrial or ventricular contractions are benign unless they are accompanied by murmurs, heart failure or cyanosis, and are thought to be caused by random firing of auxiliary pacemakers.
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Question 3 of 8
3. Question
You are called to evaluate a 3 week old infant who has an irregular heart rate. On auscultation, he is a 10% below birth weight, his heart rate is 136, irregular, and you hear a 3/6 systolic murmur at the left sternal border. An EKG confirms that he has premature ventricular contractions. What the next step?
Hint
Signs and symptoms that are concerning and warrant a further work-up in children with irregular heart rate include murmurs, heart failure and cyanosis. These findings warrant further investigation for evidence of structural heart disease.
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Question 4 of 8
4. Question
What is a common lab drawn on the mother that may confirm the etiology for congenital complete heart block in an infant without structural heart disease?
Hint
Congenital Complete Heart Block in an infant without structural heart disease is most commonly due to maternal lupus, in which anti-nuclear antibodies attack the fetus’ conduction system.
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Question 5 of 8
5. Question
How do children with complete heart block maintain their cardiac output during a stress response?
Hint
Cardiac output = Heart Rate x Stroke Volume. Children with bradycardia might not be able to increase their heart rate as needed to maintain cardiac output and thus must modify stroke volume to keep cardiac output stable.
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Question 6 of 8
6. Question
Which of the following is TRUE about tachyarrhythmias in the newborn? (Select all that apply)
Hint
Tachy means fast, and in the newborn period this means a heart rate of at least 200 beats per minute, often the result of increased catecholamines.
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Question 7 of 8
7. Question
Which of the following is the most common tachyarrhythmia in newborns?
Hint
Atrial fibrillation is the least common arrhythmia and atrial flutter occurs in only 9% of patients.
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Question 8 of 8
8. Question
Which of the following is true about supraventricular tachycardia?
Hint
SVT is the most common tachyarrhythmia, but also very difficult to treat and require the care of a cardiac electrophysiologist. Intrauterine ablation therapy poses significant risk and is not commonly performed.
