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Paediatric

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CVS

Question
46 out of 63
 

NADA’s criteria are used for (AIIMS Nov 2014)



A Assessment of child for degree of dehydration

B Assessment of child for degree of malnutrition

C Assessment of child for presence of heart disease

D Assessment of child for degree of mental retardation

Ans. C

Assessment of child for the presence of heart disease

o The assessment of a child for the absence or presence of Heart disease can be done with the help some guidelines suggested by NADA and are called NADA s criteria.

NADA’s Criteria

o Either one major or two minor criteria are necessary for indicating the presence ofher art disease.

Major Criteria

a. Systolic murmur of grade III or more.

i. The systolic murmur is classified into : -

a) Ejection systolic murmur

b) Pansystolic murmur

ii. Pansystolic murmur is always abnormal no matter what is its intensity.

iii. Only three lesions produce pansystolic murmur + i)VSD ii)A/R iil)TR

iv. Ejection systolic murmur on the other hand may be organic or functional.

v. If ejection systolic murmur is associated with thrill, it is always organic.

vi. If ejection systolic murmur is more than grade III intensity + It is organic.

vii. Grade III or less ejection systolic murmur of a functional type may be heard in anemia or high fever in otherwise normal children.

b. Diastolic murmur

i. Presence of diastolic murmur always indicates the presence of organic heart disease.

ii. There are two exceptions.

• Severe hypertension -+ Reduction of BP may cause an AR murmur to disappear.

• Anemia + May result in delayed diastolic murmur across the tricuspid and mitral area.

c. Cyanosis

i. Central cyanosis indicates presence of heart disease if lung disease has been excluded.

d. CHF

i. Presence of CHF indicates presence of heart disease except in neonates and infants who get CHF from causes such as hypoglycemia and anemia.

Minor criteria

a. Systolic murmur less than grade III in intensity.

b. Abnormal second heart sound

i. Abnormal 52 always indicates presence of heart disease.

ii. It has been included as a minor criterian only because auscultation is an individual and subjective finding.

c. Abnormal ECG

i. Main value of ECG lies in determining the : -

• Mean QRS axis

• Right or left atrial hypertrophy

• Right or left ventricular hypertrophy

d. Abnormal X-ray

i. If there is cardiomegaly in a good inspiratory film, it is highly suggestive for the presence of heart disease.

e. Abnormal BP

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