[9] Heart Failure in Children

Question 1

Formula for CO

Answer 1

CO = HR x SV

Question 2

Adult vs. Pediatric Heart Failure

Cause

Answer 2

A: Myocardial disease, ventricular systolic dysfunction

C: Volume/Pressure overload with normal contractility

Question 3

Compensatory Mechanisms for Heart Failure

Answer 3

Increased Preload
Increased Cardiac Rate
Increased Afterload

Question 4

Hallmark of Heart Failure

Answer 4

Decreased oxygen delivery

Question 5

Pharmacologic Treatment for CHF

Answer 5

D:iuretics
I:notropes
V:asodilator
A: ACE Inhibitors

Di:goxin

B:eta Blockers
A:ldosterone Antagonists

Question 6

A K-Sparing Weak Diuretic

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Answer 6

Spirolactone

Question 7

NYHA class where there is slight limitation of physical activity

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Answer 7

Class II

Question 8

Exercise intolerance and easy fatigability are hallmarks of?

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Answer 8

Congestive Heart Failure

Question 9

Heart size to cardiothoracic ratio in cardiomegaly

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Answer 9

HS:HR > 0.55

Question 10

Causes of Pediatric Heart Failure

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Answer 10

Ventricular Systolic Dysfunction

Volume Overload with Normal Ventricular Contractility

Pressure Overload with normal Ventricular Contractility

Complex Heart Disease

Question 11

Ultimately associated with alterations in cellular and subcellular phenotype reducing contractility

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Answer 11

Myocardial Hypertrophy/LV Remodelling

Question 12

Increased left ventricular end diastolic pressure and left arterial pressure leads to?

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Answer 12

Pulmonary Venous Congestion

Question 13

Symptoms of Systemic Congestion

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Answer 13

Hepatomegaly

Bipedal Edema

Question 14

Important signs of heart failure in newborns/infants

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Answer 14

Intermittency of Feeding

Dyspnea

Question 15

Important signs of heart failure in children and young adults

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Answer 15

Easy Fatigability

Tachypnea

Question 16

Signs to look for during general survey of a child suspected with HF

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Answer 16

Failure to Thrive
Anxiety
Irritability
Lacks Color
Diaphoresis
Distress

FAILDD

Question 17

Abdominal signs of cardiorespiratory distress

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Answer 17

Retraction

Harrison’s Groove

Question 18

Vital Signs of a HF Patient

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Answer 18

Sinus Tachycardia
Hypotension
Tachypnea

Question 19

T/F: Splenomegaly is associated with CHF.

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Answer 19

F. Only hepatomegaly and ascites are associated

Question 20

T/F: Peripheral edema is commonly found in infants with CHF

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Answer 20

F. It is extremely rare in infants due to presence of TR (tricuspid regurgitation)

Question 21

Drugs that can be used to increase CO

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Answer 21

Digoxin
Beta Agonists
Milrinone

Question 22

Drugs used to decrease preload

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Answer 22

Diuretics (Furosemide)
Venous Dilators (Nitroglycerin)

Question 23

Infants with Down Syndrome usually present with?

Answer 23

Complete Atrio-Ventricular Septal Defect

CAVSD