PE22.1-11 | Cardiovascular System — Glossary

Drug class (captopril, enalapril) that blocks angiotensin-converting enzyme, reducing angiotensin II production; decreases afterload, reduces aldosterone-mediated sodium retention, and inhibits ventricular remodelling in cardiac failure.

Infective endocarditis with a rapid, fulminant presentation over days, characterised by high fever, rapid valve destruction, and early embolic complications; most commonly caused by Staphylococcus aureus.

An autoimmune inflammatory disease triggered by Group A streptococcal pharyngitis and caused by molecular mimicry, affecting the heart (carditis), joints (migratory polyarthritis), CNS (chorea), and skin (erythema marginatum, subcutaneous nodules).

A category of structural cardiac defects present at birth that do not cause central cyanosis at presentation, including left-to-right shunt lesions (VSD, ASD, PDA) and obstructive lesions (PS, AS, CoA), in which pulmonary blood remains oxygenated.

24-hour BP recording using an automated cuff; the gold standard for confirming white-coat hypertension and assessing nocturnal dipping in children.

A catheter-deployable self-expanding nitinol device used for percutaneous closure of ostium secundum atrial septal defects and select muscular VSDs; it has largely replaced surgical repair for anatomically suitable defects.

Amoxicillin 50 mg/kg oral (max 2 g) given 30–60 minutes before dental procedures; recommended only for the five highest-risk CHD categories per AHA/IAP guidelines — not for all CHD.

The lowest and outermost point at which the cardiac impulse is palpable on the chest wall; normally at the 4th intercostal space at or medial to the midclavicular line in children under 7 years.

The definitive surgical repair for D-TGA performed within the first 2 weeks of life, in which the great arteries are transected and re-anastomosed to their correct ventricles along with coronary artery transfer.

The pathognomonic granulomatous lesion of rheumatic myocarditis; consists of a central area of fibrinoid necrosis surrounded by Anitschkow myocytes (caterpillar cells), giant cells, and lymphocytes; found in the myocardium and endocardium.

A serological marker of recent Group A Streptococcal infection; significant value >200 Todd units in children; rises 3–4 weeks after pharyngitis; may normalise by 6–8 weeks; constitutes evidence of preceding GAS for Jones Criteria.

The primary anti-inflammatory agent for ARF, used for arthritis and mild/moderate carditis; dose 60–100 mg/kg/day in 4 divided doses; response is dramatic and diagnostically supportive; no role in Sydenham chorea management.

An opening in the interatrial septum; ostium secundum type is the most common (~70%) and is characterised by wide fixed splitting of S2 and a pulmonary ejection systolic murmur, with right axis deviation and RBBB on ECG.

QTc = QT (seconds) ÷ √RR interval (seconds); used to correct the measured QT interval for heart rate, allowing comparison against the normal threshold of <0.44 s regardless of rate.

A long-acting IM formulation of penicillin; used for both GAS eradication (single dose) and secondary prophylaxis (every 3–4 weeks for years); dose 600,000 IU (<27 kg) or 1,200,000 IU (≥27 kg) IM.

Combined ECG features of both RVH and LVH; the Katz-Wachtel pattern (large biphasic RS complexes in mid-precordial leads V3-V4) is a characteristic finding, seen in large ventricular septal defects.

Three sets of blood cultures from three separate venepunctures at separate sites, each set containing aerobic and anaerobic bottles, drawn before any antibiotic is given; minimum volume 1–3 mL per bottle in children.

A natriuretic hormone released from distended ventricular myocardium in proportion to wall stress; elevated in cardiac failure; useful for distinguishing cardiac from respiratory dyspnoea and for monitoring treatment response.

A radiological appearance of the heart in tetralogy of Fallot — upturned cardiac apex (due to right ventricular hypertrophy) with a concave pulmonary artery segment, resembling a boot or coeur en sabot.

The cuff bladder width should be ≥40% and length 80–100% of the child's arm circumference to ensure accurate blood pressure measurement.

An intracranial abscess caused by septic emboli bypassing pulmonary filtration via a right-to-left cardiac shunt; most common in children >2 years with uncorrected cyanotic CHD, particularly TOF.

An ACE inhibitor used as afterload reduction in infants with large L→R shunts causing cardiac failure; weight-based dose 0.1–0.3 mg/kg/dose every 6–8 hours; lowers systemic vascular resistance, reducing the magnitude of the L→R shunt.

A clinical syndrome in which the heart cannot deliver adequate cardiac output to meet metabolic demands, or can only do so at the expense of elevated filling pressures, resulting in symptoms of congestion and/or low output.

Enlargement of the cardiac shadow on chest X-ray, defined by the CT ratio exceeding age- and projection-specific thresholds; indicates volume or pressure overload of the heart.

The ratio of the maximum horizontal cardiac shadow width to the maximum internal thoracic diameter on a chest X-ray; >0.55 on PA view (children >2 years) or >0.60 on AP view (infants) indicates cardiomegaly.

The ratio of the widest cardiac diameter to the widest internal chest diameter on a frontal chest X-ray; a ratio >0.55 in infants (>0.50 in older children) indicates cardiomegaly.

Pancarditis involving pericardium, myocardium, and endocardium (valvulitis) in ARF; the most important manifestation as it is the only one that causes permanent organ damage; the mitral valve is most commonly involved.

A non-selective beta-blocker with additional alpha-1 adrenergic blockade; used in chronic stable paediatric cardiac failure from ventricular dysfunction; dose 0.05–0.4 mg/kg/dose bd; initiated at low dose and up-titrated.

A congenital narrowing of the aorta, most commonly at the level of the ligamentum arteriosum in the post-ductal position; presents with upper limb hypertension, weak or absent femoral pulses, and rib notching on CXR in older children.

French for 'boot-shaped heart'; the classic chest X-ray appearance in TOF caused by right ventricular hypertrophy (upturned apex) and reduced pulmonary vascular markings.

Third-degree atrioventricular block in which no atrial impulses reach the ventricles; P waves and QRS complexes are completely dissociated with different rates; requires pacemaker insertion.

A group of congenital heart defects in which deoxygenated blood bypasses the pulmonary circulation and enters the systemic arterial supply, causing persistent central cyanosis from right-to-left intracardiac or great-vessel shunting.

Dietary Approaches to Stop Hypertension — an eating pattern rich in fruits, vegetables, whole grains, and low-fat dairy, with reduced saturated fat and sodium, shown to lower blood pressure.

A slurred upstroke at the beginning of the QRS complex on ECG, caused by early (pre-excitation) activation of the ventricle via an accessory pathway; pathognomonic of Wolff-Parkinson-White syndrome.

A pattern in which cyanosis and clubbing are present in the lower limbs but absent in the upper limbs (and face), pathognomonic of a reversed PDA Eisenmenger syndrome where desaturated blood enters the descending aorta below the ductus while upper-body vessels receive oxygenated blood from the aortic arch.

A chromosomal microdeletion syndrome (22q11.2) associated with conotruncal cardiac defects (truncus arteriosus, TOF, interrupted aortic arch), T-cell immunodeficiency, hypocalcaemia, and dysmorphic facies.

A cardiac glycoside with positive inotropic effects (inhibits Na/K-ATPase → increased intracellular calcium) and AV node slowing via vagal enhancement; used in paediatric cardiac failure and arrhythmias; digitalising dose varies by age (20–40 mcg/kg); narrow therapeutic index (0.8–2.0 ng/mL).

Toxicity from excess digoxin manifesting as vomiting, bradycardia, AV block, and visual disturbances; precipitated by hypokalaemia; managed by withholding digoxin, checking serum levels and electrolytes, and Fab fragments in severe cases.

A myocardial disease characterised by dilatation and systolic dysfunction of one or both ventricles; the most common cardiomyopathy in children; may be idiopathic, viral (post-myocarditis), familial, or metabolic.

A selective beta-1 adrenergic agonist used for inotropic support in acute decompensated cardiac failure; dose 5–20 mcg/kg/min IV; increases heart rate and contractility; requires ECG monitoring for arrhythmias.

The characteristic CXR appearance in D-TGA showing a narrow superior mediastinum (parallel great vessels without crossing) and cardiomegaly, resembling an egg lying on its side.

A radiological description of the mediastinal shadow on chest X-ray in transposition of the great arteries — the narrow, stalk-like superior mediastinum with an enlarged cardiac shadow, resembling an egg on a string.

The irreversible complication of large untreated L→R shunt lesions in which chronic pulmonary overcirculation causes progressive obliterative pulmonary arterial hypertension; when pulmonary vascular resistance equals or exceeds systemic vascular resistance, the shunt reverses to R→L causing central cyanosis, rendering surgical repair fatal.

Blood pressure between the 90th and <95th percentile for age, sex, and height, or ≥120/80 mmHg (whichever is lower) — the current term replacing 'pre-hypertension' in children.

An evanescent, non-pruritic rash with pale centres and raised serpiginous red borders on the trunk and proximal limbs (never the face); a major Jones criterion; present in <10% of ARF cases.

A pattern of inadequate weight gain or weight loss in infancy; in cardiac failure, results from increased metabolic demands combined with reduced caloric intake (feeding difficulty) and malabsorption from gut congestion.

Non-atherosclerotic, non-inflammatory disease of medium-sized arteries (especially renal arteries) causing stenosis and renovascular hypertension, more common in young females.

A radiological sign on CXR in coarctation of the aorta representing indentation of the aortic knuckle at the coarctation site with pre- and post-stenotic dilatation, creating a '3' or 'reverse-3 (E)' shape visible on barium swallow.

Persistence of a wide split between A2 and P2 that does not vary with respiration; the classic auscultatory sign of an atrial septal defect.

A staged surgical palliation for single-ventricle hearts (including tricuspid atresia) that directs all systemic venous return directly to the pulmonary arteries without a ventricular pump, completing the total cavopulmonary connection.

A loop diuretic used in paediatric anti-failure therapy for CHD; weight-based dose 1–2 mg/kg/dose orally or IV, 1–2 times daily; reduces pulmonary oedema and systemic venous congestion.

Furosemide causes hypokalaemia by increasing potassium loss in the distal nephron; concurrent digoxin therapy requires potassium monitoring and supplementation because hypokalaemia potentiates digoxin toxicity.

A group of slow-growing gram-negative bacilli (Haemophilus, Aggregatibacter, Cardiobacterium, Eikenella, Kingella) that are an important cause of culture-negative IE; require extended blood culture incubation (5–7 days).

A histopathological grading system (grades I–VI) of pulmonary vascular changes in pulmonary arterial hypertension secondary to CHD, from medial hypertrophy (grade I) through intimal proliferation to plexiform lesions and fibrinoid necrosis (grade VI); grades IV–VI are irreversible.

A rise in JVP during sustained right upper quadrant abdominal pressure; a positive test (>3 cm rise) indicates elevated right-sided filling pressure; more reliable than direct JVP in young children.

A diagnostic test for neonatal cyanosis in which arterial PaO₂ is measured after 10–15 minutes of 100% oxygen; PaO₂ remaining <150 mmHg (usually <100 mmHg) strongly suggests a cardiac (right-to-left shunt) rather than a respiratory cause.

Average blood pressure ≥95th percentile for age, sex, and height on at least three separate occasions in children aged ≥1 year.

Severely elevated blood pressure associated with acute end-organ damage such as hypertensive encephalopathy, acute left ventricular failure, or acute renal failure.

A clinical syndrome of severely elevated BP causing cerebral oedema and dysfunction, manifesting as severe headache, altered consciousness, visual disturbances, and seizures.

A non-selective COX inhibitor used as a first-line pharmacological agent to promote closure of haemodynamically significant PDA in premature neonates; dose 0.1–0.2 mg/kg IV; contraindicated in renal failure, coagulopathy, and NEC.

A microbial infection of the endocardial surface of the heart, most commonly the cardiac valves, characterised by vegetation formation, valve destruction, and risk of embolic complications.

A cardiac murmur occurring without any structural cardiac abnormality; characteristically soft, short, systolic, with no radiation, no thrill, normal S2, and no associated symptoms.

Non-tender, flat haemorrhagic macules on the palms and soles in IE; caused by septic microemboli; more common in acute IE (Staph aureus); a minor Duke criterion (vascular phenomenon).

The current diagnostic criteria for ARF, with separate thresholds for high-risk populations (including India) and low-risk populations; diagnosis requires 2 major, or 1 major + 2 minor criteria, plus evidence of preceding GAS infection.

The height of the blood column in the internal jugular vein above the sternal angle, reflecting right atrial pressure; elevated in right heart failure, constrictive pericarditis, and tamponade.

Large biphasic (deep S and tall R, or tall R and deep S) QRS complexes in the mid-precordial leads (V3-V4) on ECG; a sign of biventricular hypertrophy, classically seen in large ventricular septal defects.

A sustained lifting impulse palpable along the left sternal border, indicating right ventricular hypertrophy or dilatation due to conditions such as pulmonary hypertension or large left-to-right shunts.

ECG pattern indicating increased left ventricular muscle mass — tall R in V5-V6, deep S in V1, left-axis deviation, T-wave inversion in lateral leads (strain pattern).

Abnormal blood flow from the higher-pressure left side of the heart to the lower-pressure right side through a congenital defect, resulting in increased pulmonary blood flow and volume overload of the pulmonary circulation and left heart.

Compensatory thickening of the left ventricular wall in response to sustained pressure overload; the most important hypertensive target-organ finding in children, detected by ECG or echocardiography.

A 1–6 grading scale for heart murmur intensity: Grade 1 (barely audible) to Grade 6 (audible without a stethoscope); Grade 4–6 have an associated palpable thrill.

A channelopathy (mutation in cardiac potassium or sodium channels) causing prolonged ventricular repolarisation (QTc >0.44 s); predisposes to torsades de pointes and sudden cardiac death, typically triggered by exercise or emotional stress.

Mean arterial pressure = diastolic BP + 1/3 pulse pressure; the target for controlled BP reduction in hypertensive emergencies is no more than 25% reduction in the first 8 hours.

A murmur starting after S1, reaching a crescendo, then decrescendo before S2 (diamond-shaped); produced by aortic stenosis, pulmonary stenosis, or innocent flow murmurs.

A large-joint arthritis in ARF that moves from joint to joint in an additive-then-migratory pattern; disproportionately painful relative to clinical signs; responds dramatically to aspirin within 24–48 hours; leaves no permanent joint damage.

A phosphodiesterase-3 inhibitor that increases cAMP, producing positive inotropy and vasodilation (inodilator); dose 0.25–0.75 mcg/kg/min IV; preferred in post-cardiac surgery failure and when tachycardia from dobutamine is undesirable.

A palliative surgical shunt between the subclavian artery and pulmonary artery using a synthetic graft, used to increase pulmonary blood flow in decreased-flow cyanotic CHD as a bridge to definitive repair.

A diagnostic scoring system for IE based on two major criteria (positive blood cultures with typical organisms; echo evidence of endocardial involvement) and five minor criteria; definite IE requires 2 major, or 1 major + 3 minor, or 5 minor criteria.

An autoimmune mechanism in which antibodies or T cells raised against a foreign antigen (GAS M protein) cross-react with structurally similar host proteins (cardiac myosin), causing tissue damage — the central pathogenic mechanism of ARF carditis.

Inflammatory disease of the myocardium, most commonly viral in children (coxsackievirus B, adenovirus); presents with rapid-onset cardiac failure, ECG changes, and elevated cardiac enzymes; can evolve to dilated cardiomyopathy.

Painful, tender, reddish-purple nodules on the finger and toe pads in IE; caused by immune complex deposition (not septic emboli); typically last days; a minor Duke criterion (immunological phenomenon).

Tall, peaked P waves (>2.5 mm amplitude) in lead II on ECG, indicating right atrial enlargement; seen in conditions causing right atrial volume or pressure overload (pulmonary hypertension, pulmonary stenosis, tricuspid stenosis).

A murmur occupying the entire systole from S1 to S2 without any gap; typically produced by VSD (left lower sternal border), mitral regurgitation (apex, radiates to axilla), or tricuspid regurgitation.

Persistence of the fetal ductus arteriosus connecting the pulmonary artery to the aorta after birth; clinically produces a continuous machinery murmur at the upper left sternal border and bounding pulses with wide pulse pressure.

An IV medication used in duct-dependent cyanotic CHD that keeps the ductus arteriosus patent by relaxing ductal smooth muscle; dose 0.05–0.1 mcg/kg/min; key side effect is apnoea.

Catecholamine-secreting tumour of the adrenal medulla (or extra-adrenal paraganglia) causing episodic or sustained hypertension with headache, palpitations, and sweating.

Compensatory increase in red cell mass (haematocrit >65%) in response to chronic hypoxaemia, driven by erythropoietin; causes hyperviscosity, thrombosis, and paradoxically concurrent iron deficiency.

Visible prominence of the left precordium due to cardiomegaly from longstanding cardiac enlargement; suggests a haemodynamically significant lesion such as a large VSD, PDA, or rheumatic valvular disease.

Another term for precordial bulge — visible prominence of the chest wall over the cardiac area indicating cardiomegaly.

Hypertension without an identifiable underlying cause, arising from polygenic predisposition and environmental factors; more common in overweight adolescents.

A prostaglandin used intravenously at 0.05–0.1 mcg/kg/min to maintain ductal patency in neonates with duct-dependent congenital heart disease (e.g. critical coarctation); apnoea is a dose-dependent side effect requiring monitoring.

Elevated pulmonary artery pressure (mean >20 mmHg) in children; recognised on examination by a loud P2, left parasternal heave, and right ventricular enlargement on echo.

Reduced pulmonary vascular markings on chest X-ray, giving a hyperlucent lung appearance; indicates decreased pulmonary blood flow, seen in right-to-left shunts such as tetralogy of Fallot.

Increased and prominent pulmonary vascular markings on chest X-ray extending to the lung periphery, indicating increased pulmonary blood flow as seen in large L→R shunt lesions.

The resistance to blood flow offered by the pulmonary vasculature, normally low after birth; chronic exposure to high-pressure, high-flow shunted blood causes progressive PVR elevation through medial hypertrophy and intimal proliferation.

The ratio of pulmonary (Qp) to systemic (Qs) blood flow, calculated by the Fick principle or estimated by echocardiography; a ratio >1.5:1 indicates a significant shunt and >2:1 is haemodynamically significant with clinical symptoms.

The rate-corrected QT interval (duration of ventricular systole), calculated using the Bazett formula: QTc = QT/√RR; normal <0.44 s in children; >0.47 s indicates significant prolongation with risk of torsades de pointes.

Renin-angiotensin-aldosterone system — a hormonal cascade that regulates blood pressure and fluid balance; dysregulated in renovascular and renal parenchymal hypertension.

A clinical sign in coarctation of the aorta where the femoral pulse arrives measurably later than the radial pulse, reflecting the pressure gradient across the coarctation.

An emergency catheter-based palliation for TGA in which a balloon catheter tears the interatrial septum to create an adequate ASD, improving mixing between the parallel circulations.

Diseases affecting renal cortex and medulla (glomerulonephritis, reflux nephropathy, CKD) — the most common cause of secondary hypertension in children.

Hypertension caused by reduced renal artery perfusion (from stenosis due to fibromuscular dysplasia or Takayasu's) leading to RAAS activation and hyperreninaemia.

Permanent valvular damage resulting from repeated episodes of rheumatic carditis; the mitral valve is most commonly affected; the leading cause of acquired heart disease in children in developing countries.

Erosion of the undersurface of ribs 3–8 visible on chest X-ray in coarctation of the aorta, caused by hypertrophied intercostal collateral arteries that bypass the obstruction; typically develops only after 5 years of age.

ECG pattern indicating increased right ventricular muscle mass — tall R in V1 (beyond the neonatal period), upright T in V1 in neonates/infants, right-axis deviation, deep S in V5-V6.

Narrowing at the infundibulum or pulmonary valve that impedes blood flow from the right ventricle to the pulmonary artery, forcing blood across the VSD in TOF.

A paediatric heart failure staging system (Grades I–IV) analogous to the adult NYHA classification, adapted for age-specific symptoms — particularly feeding difficulty and growth failure in infants.

Oval retinal haemorrhages with pale centres seen on fundoscopy in IE; caused by immune complex deposition in retinal vessels; a minor Duke criterion (immunological phenomenon).

The heart sound produced by mitral and tricuspid valve closure at the start of ventricular systole; best heard at the apex and lower sternal border.

The heart sound produced by aortic (A2) and pulmonary (P2) valve closure at the end of systole; physiological splitting widens with inspiration.

A low-pitched early diastolic sound at the apex caused by rapid ventricular filling; physiological in children under 12 years but pathological in older individuals.

A presystolic low-pitched sound at the apex caused by atrial contraction into a non-compliant ventricle; always pathological in children.

Antibiotic prophylaxis given before dental or invasive procedures to prevent bacterial seeding of abnormal cardiac endothelium; per IAP/AHA guidelines, amoxicillin 50 mg/kg orally (max 2 g) is indicated for high-risk CHD categories (unrepaired cyanotic CHD, prosthetic valves, previous endocarditis) — not all CHD.

Hypertension due to an identifiable underlying disorder — most commonly renal parenchymal disease in children; predominates in younger children.

Long-term regular penicillin administration (benzathine penicillin G every 3 weeks) to prevent recurrent GAS pharyngitis and thereby prevent recurrent ARF episodes; duration depends on severity of cardiac involvement — up to lifelong for severe RHD.

Physiological variation in heart rate with the respiratory cycle (faster with inspiration, slower with expiration); normal in children and does not require investigation.

A radiological appearance in supracardiac total anomalous pulmonary venous connection (TAPVC) — the figure-of-eight or snowman shape formed by the enlarged cardiac shadow (body) and the dilated vertical vein/SVC above it (head).

The CXR appearance in supracardiac TAPVC where the dilated vertical vein and SVC form the upper circular shadow and the enlarged right heart forms the lower, producing a figure-of-8 or snowman silhouette.

Linear reddish-brown streaks in the mid-nail under the nail plate in IE; caused by microemboli in nail-bed capillaries; part of the peripheral stigmata picture.

Peripheral oxygen saturation measured by pulse oximetry; normal ≥95% at sea level; pre-ductal (right hand) vs post-ductal (foot) comparison is important in neonates with suspected ductal-dependent circulation.

Blood pressure between the 95th percentile and the 99th percentile plus 5 mmHg, confirmed on three occasions.

Blood pressure above the 99th percentile plus 5 mmHg — requires prompt evaluation and often pharmacotherapy.

Coagulase-positive gram-positive coccus; most common cause of acute, destructive IE; can infect normal valves; associated with IV catheters, skin infections, and post-cardiac surgery; MRSA strains require vancomycin.

The most common innocent murmur in children aged 2–7 years; soft (Grade 1–2), short midsystolic, vibratory or musical quality, best heard at the lower left sternal border, diminishes with standing.

Alpha-haemolytic oral streptococci; normal oral flora; most common cause of subacute IE following dental procedures in children with structural CHD or rheumatic valve disease; relatively indolent presentation.

Infective endocarditis with an indolent, weeks-long presentation characterised by low-grade fever, weight loss, and gradual development of peripheral stigmata; most commonly caused by Streptococcus viridans on pre-existing abnormal valves.

Echocardiographically proven mitral or aortic regurgitation due to rheumatic valvulitis without an audible murmur on auscultation; counts as a major Jones criterion in high-risk populations per the 2015 revision.

Firm, non-tender nodules over bony prominences (occiput, olecranon, patella) in ARF; a major Jones criterion; present in <5% of cases; associated with severe carditis.

A rapid tachyarrhythmia originating above the bundle of His (typically via re-entry); heart rate >200/min in infants; sustained SVT causes tachycardia-induced cardiomyopathy and cardiac failure; treated with adenosine or cardioversion.

An involuntary, purposeless, non-rhythmic movement disorder affecting the face and limbs, caused by autoimmune attack on the basal ganglia; a late manifestation of ARF (3–6 months after GAS infection); treated with haloperidol or carbamazepine, not aspirin.

A cyanotic CHD in which all four pulmonary veins drain anomalously into the right heart or systemic veins instead of the left atrium, with an obligate ASD providing systemic output.

An acute episode in TOF of sudden profound cyanosis, hyperpnoea, and agitation triggered by increased RVOTO or reduced systemic vascular resistance; managed with knee-chest position and morphine.

The most common cyanotic CHD, characterised by four anatomical defects: VSD, RVOTO (infundibular stenosis), overriding aorta, and RV hypertrophy.

A palpable vibration felt over the precordium, corresponding to a Grade 4 or higher murmur on the Levine scale; always indicates pathological turbulent blood flow.

A cyanotic CHD in which the aorta arises from the morphological RV and the pulmonary artery from the LV (ventriculo-arterial discordance), creating two parallel circulations that require mixing to sustain life.

A cyanotic CHD characterised by complete absence of the tricuspid valve, obligate right-to-left atrial shunting via ASD, hypoplastic RV, and characteristic left axis deviation on ECG.

A cyanotic CHD characterised by a single arterial trunk arising from both ventricles overriding a VSD, giving rise to the aorta, pulmonary arteries, and coronary arteries.

A glycopeptide antibiotic used for MRSA infective endocarditis and for penicillin-allergic patients; requires monitoring of trough levels to avoid nephrotoxicity; drug of choice for prosthetic valve IE empirically.

An oscillating mass of platelets, fibrin, and bacteria attached to the endocardial surface; the hallmark lesion of IE; relatively avascular and shielded from antibiotics, explaining the need for prolonged parenteral therapy.

The most common congenital heart defect, comprising an opening in the interventricular septum; the membranous (perimembranous) type is most common (~80%) and produces a pansystolic murmur at the lower left sternal border.

BP elevated during clinic measurements but normal on ambulatory monitoring; common in children and requires 24-hour ambulatory BP monitoring to confirm.

A pre-excitation syndrome in which an accessory electrical pathway between the atria and ventricles causes a short PR interval, delta wave, and wide QRS on ECG; associated with paroxysmal supraventricular tachycardia.