7.14 Peds Cardio Flashcards
When does the fetal heart begin to beat?
Day 23 after conception
Formation of the fetal heart is complete by when?
The 8th week
Compare ventricles at birth. Why is this?
Right ventricle is larger than the left due to high pulmonary resistance during fetal life.
What limits blood flow into fetal lungs? How is it redirected?
High pulmonary vascular resistance limits flow into the lungs
Redirected through patent ductus arteriosus (PDA)
When is the Patent ductus arteriosus closed?
10-15 hours after birth
Why is neonatal and infant myocardial muscle less efficient? (2)
- Fewer organized myocardial fibers
- More sensitive to volume pressure overload
How do neonate heart sounds compare to those of an adult? (2)
Neonatal heart sounds:
- Higher pitched
- Greater intensity
What is the pulse pressure in an infant?
Difference between systolic and diastolic (normally 20 to 50 mmHg)
How does Newborn’s heartrate compare to adult’s?
- Higher heart rate (100 to 180)
How does Newborn’s respiratory rate compare to that of an adults?
- Higher RR (30 to 40)
How does a newborn’s BP compare to that of an adult’s?
75/49 (Lower)
Acrocyanosis
Normal finding in infants
Vibratory sensation over the precordium, indicated turbulent blood flow is a _____
Thrill
A PMI which is diffuse and rises slowly
Heave
Where is PMI in newborns / infants? (What does this indicate?)
Left lower sternal border (Indicates RV dominance)
In what position should you auscultate the child?
Two: Sitting, reclining
What causes S3?
- COMMON in kids and young adults
- Caused by vibrations in the ventricle as it fills rapidly during diastole
What does S4 suggest?
- Rare
- Suggests decreased ventricular compliance
How are murmurs graded?
Scale from I to VI
(4-6 with a thrill)
Six - audible without stethoscope
Murmurs occur in ___% of children
30-50%
Six attributes of a pathologic murmur in kids
- Systolic click
- S4 Gallop
- Diastolic or pan-systolic
- Not positional
- Associated with a thrill
- III or above
Six attributes of an innocent murmur
- Occurs with S1
- Loudest in Pulmonic area – well located
- Vibratory or musical quality
- Short duration
- Grade III or less intensity
- Variable relationship to position / activity
What is the most common Congenital Heart Disesae?
Ventricular Septal Defect (VSD)
How are Congenital Heart Defects classified?
Hemodynamic characteristics (Blood Flow)
What is a Ventricular Septal Defect?
Opening between right and left ventricle, allowing blood from the higher pressure left ventricle to flow into the right ventricle (leads to right ventricular hypertrophy)
What is Tetralogy of Fallot
VSD with Overriding aorta and right ventricular hypertrophy
What is Coarctation of the Aorta?
Localized narrowing of the aorta near the ductus arteriosus
