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Peds Exam 2 > Acyanotic Heart Defects > Flashcards

Acyanotic Heart Defects Flashcards

1
Q

arterial septal defect (ASD)

A

a birth defect of the heart in which there is a hole in the wall (septum) that divides the upper chambers (atria) of the heart.

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2
Q

clinical manifestations of ASD

A

may be asymptomatic
heart murmur
CHF

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3
Q

children with ASD are at an increased risk of

A

increased risk of dysrhythmias with pulmonary vascular obstructive disease and emboli later in life

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4
Q

treatment of ASD

A

mild defects may close spontaneously
open heart
dacron patch closure
may be closed using devices (septal occluder) during heart cath

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5
Q

Ventricular septal defect

A

septum fails to completely form between the right and left ventricles, pinpoint to total absence

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6
Q

clinical manifestations of ventricular septal defect

A 
CHF; mod to severe, cyanosis
characteristic murmur
right ventricular hypertrophy
FTT
fatigue
recurrent respiratory infections
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7
Q

therapeutic management of ventricular septal defects

A

pulmonary artery banding
may close spontaneous by age 3
interventional heart cath with septal occluder or surgical correction with a patch and repair of AV valve tissue

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8
Q

increased pulmonary blood flow defects

A

ASD
Ventricular septal defects
Patent ductus arteriosus (PDA)

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9
Q

patent ductus arteriosus (PDA)

A

fetal structure fails to close, blood is shunted from the aorta to the pulmonary artery

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10
Q

clinical manifestations for PDA

A

machine like murmur
can be asymptomatic
CHF

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11
Q

treatment of PDA

A

indomethacin (prostaglandin E inhibitor)
interventional heart cath with coil
LT thoracotomy or VATS

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12
Q

what is a VATS

A

video assisted thoroscopic surgery

3 small incisions on LT side of chest to place a clip on on the ductus

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13
Q

what causes obstructive lesions

A

blood exiting the heart meets an area of anatomic narrowing, causing obstruction to blood flow

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14
Q

where does the obstructive lesions form?

A

near the valve as in aortic and pulmonic stenosis

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15
Q

consequences of obstructive lesions

A

either shunting ( LT to right) or back-up of blood on the right side
increased pulmonary congestion
signs of CHF

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16
Q

coarctation of aorta

A

localized narrowing of aorta near the insertion of the ductus arteriosus, resulting in increased pressure proximal to the defect ( head and upper extremities’) and decreased pressure distal to the defect (body & lower extremities)

17
Q

what are the two locations of coarctation of the aorta

A

preductal- between subclavian artery before the ductus arteriosus
postductal- collateral circulation develops during fetal life (distal to the ductus arteriosus)

18
Q

clinical consequences of coarctation of the aorta

A

L-R shunting, increased pulmonary blood flow leading to CHF
increased blood flow to head and upper extremities
decreased blood flow to trunk and lower extremities

19
Q

therapeutic management of coarctation of aorta

A

prostaglandin E to maintain PDA
Balloon angioplasty
surgery within the first 2 years

20
Q

obstructive blood flow defects

A

coarctation of aorta
aortic stenosis
pulmonic stenosis

21
Q

aortic stenosis

A

narrowing or stricture of aortic valve causing resistance to blood flow out of left ventricle
results in decreased cardiac output, left ventricular hypertrophy, and pulmonary vascular congestion.

22
Q

serious effects of aortic stenosis

A

obstruction tends to be progressive
sudden episodes of myocardial ischemia, or low cardiac output, can result in SUDDEN DEATH. Only defect where ACTIVITY IS LIMITED.
surgical repair rarely results in a normal valve.

23
Q

clinical manifestations of aortic stenosis in infants

A 
faint pulses
hypotension
tachycardia
poor feeding
decreased cardiac output
24
Q

clinical manifestations of aortic stenosis in children

A

exercise intolerance, chest pain, and dizziness when standing for long periods

25
Q

treatment of aortic stenosis

A

balloon dilation or
surgery; aortic valvotomy or replacement .
Mortality high in NB low for older kids

26
Q

what is restricted in kids with aortic stenosis?

A

activity level
children are not on bedrest, but activity level is restricted (can watch movies instead of going outside, play legos instead of riding a bike, take elevator instead of stairs)
NO STRENUOUS ACTIVITY

27
Q

pulmonic stenosis

A

narrowing at the entrance to the pulmonary artery

28
Q

pulmonary atresia

A

extreme form of pulmonic stenosis, total fusion resulting in no blood flow to the lungs

29
Q

clinical manifestations of pulmonic stenosis

A

may be asympotmatic

some have mild cyanosis, CHF or murmur

30
Q

treatment of pulmonic stenosis

A

balloon angioplasty

surgery

31
Q

acyanotic defects in summary

A

shunting from LT to RT
increased pulmonary vascular congestion
monitor for signs of CHF
tachypnea, diaphoresis, eating problems, edema, rales, crackles

Peds Exam 2 (13 decks)

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