[9] Heart Failure in Children Flashcards
Formula for CO
CO = HR x SV
Adult vs. Pediatric Heart Failure
Cause
A: Myocardial disease, ventricular systolic dysfunction
C: Volume/Pressure overload with normal contractility
Compensatory Mechanisms for Heart Failure
Increased Preload
Increased Cardiac Rate
Increased Afterload
Hallmark of Heart Failure
Decreased oxygen delivery
Pharmacologic Treatment for CHF
D:iuretics
I:notropes
V:asodilator
A: ACE Inhibitors
Di:goxin
B:eta Blockers
A:ldosterone Antagonists
A K-Sparing Weak Diuretic
c/o Piperno, Poblete, Ragasa
Spirolactone
NYHA class where there is slight limitation of physical activity
(c/o Piperno, Poblete, Ragasa)
Class II
Exercise intolerance and easy fatigability are hallmarks of?
c/o Piperno, Poblete, Ragasa
Congestive Heart Failure
Heart size to cardiothoracic ratio in cardiomegaly
c/o Piperno, Poblete, Ragasa
HS:HR > 0.55
Causes of Pediatric Heart Failure
c/o Piperno, Poblete, Ragasa
Ventricular Systolic Dysfunction
Volume Overload with Normal Ventricular Contractility
Pressure Overload with normal Ventricular Contractility
Complex Heart Disease
Ultimately associated with alterations in cellular and subcellular phenotype reducing contractility
(c/o Piperno, Poblete, Ragasa)
Myocardial Hypertrophy/LV Remodelling
Increased left ventricular end diastolic pressure and left arterial pressure leads to?
(c/o Piperno, Poblete, Ragasa)
Pulmonary Venous Congestion
Symptoms of Systemic Congestion
c/o Piperno, Poblete, Ragasa
Hepatomegaly
Bipedal Edema
Important signs of heart failure in newborns/infants
c/o Piperno, Poblete, Ragasa
Intermittency of Feeding
Dyspnea
Important signs of heart failure in children and young adults
(c/o Piperno, Poblete, Ragasa)
Easy Fatigability
Tachypnea
Signs to look for during general survey of a child suspected with HF
(c/o Piperno, Poblete, Ragasa)
Failure to Thrive Anxiety Irritability Lacks Color Diaphoresis Distress
FAILDD
Abdominal signs of cardiorespiratory distress
c/o Piperno, Poblete, Ragasa
Retraction
Harrison’s Groove
Vital Signs of a HF Patient
c/o Piperno, Poblete, Ragasa
Sinus Tachycardia
Hypotension
Tachypnea
T/F: Splenomegaly is associated with CHF.
c/o Piperno, Poblete, Ragasa
F. Only hepatomegaly and ascites are associated
T/F: Peripheral edema is commonly found in infants with CHF
c/o Piperno, Poblete, Ragasa
F. It is extremely rare in infants due to presence of TR (tricuspid regurgitation)
Drugs that can be used to increase CO
c/o Piperno, Poblete, Ragasa
Digoxin
Beta Agonists
Milrinone
Drugs used to decrease preload
c/o Piperno, Poblete, Ragasa
Diuretics (Furosemide) Venous Dilators (Nitroglycerin)
Infants with Down Syndrome usually present with?
Complete Atrio-Ventricular Septal Defect
CAVSD
