ACYANOTIC HEART DEFECTS Flashcards
VSD, ASD, PDA, COA, PS
heart or circulatory anomalies that involve either a stricture to the flow of blood or
a shunt that moves blood from the arterial to the venous system (oxygenated to unoxygenated blood, or left-toright
shunts)
Acyanotic heart disorders
5 acyanotic heart defects
- VSD: ventricular septal defect
- ASD: atrial septal defect
- PDA: patent ductus arteriosus
- PS: Pulmonary stenosis
- COA: coarctation of aorta
most common sign of acyanotic heart defects
Audible murmurs
ACYANOTIC HEART DEFECTS
SIGNS AND SYMPTOMS
- Audible murmurs
- Easy fatigability shown as brow sweating (during feeding or crying episodes)
- Hepatomegaly – due to backup of blood
ACYANOTIC HEART DEFECTS
COMPLICATIONS
- Congestive Heart Failure most common complication
- Respiratory distress manifested by: moist cough, diaphoresis, severe dyspnea
What is the direction of the shunt in most cases of Ventricular Septal Defect (VSD)?
Left to right shunt.
What is the anatomical defect in a Ventricular Septal Defect?
An abnormal opening between the left and right ventricles.
What percentage of congenital heart defects (CHD) is accounted for by Ventricular Septal Defect (VSD)?
30%.
What happens to the right ventricle (RV) and pulmonary circulation in Ventricular Septal Defect (VSD)?
Overloading of the right ventricle and pulmonary circulation.
What complications can arise due to the increased pressure from VSD?
Pulmonary hypertension and respiratory failure.
What is the name of the syndrome that occurs when the shunt reverses from right to left due to pulmonary hypertension?
EISENMENGER SYNDROME
What is a potential outcome if pulmonary hypertension progresses in VSD patients?
Reverse shunt (right to left) may develop, leading to Eisenmenger syndrome.
An abnormal opening between the atria that causes increased flow of oxygenated blood into the right side of the heart.
Atrial Septal Defect (ASD)
What is the cause of an Atrial Septal Defect (ASD)?
Failure of the atrial septum to close.
What are the three major types of ASD?
ASD 1 (Ostium primum): Opening at the lower end of the septum.
ASD 2 (Ostium secundum): Opening near the center of the septum.
ASD 3 (Sinus venosus defect): Opening near the junction of the superior vena cava (SVC) and the right atrium.
Which type of ASD is most likely to cause heart failure symptoms?
Ostium primum defect (ASD 1).
Where is the defect located in Ostium Secundum (ASD 2)?
Near the center of the septum.
What is the common location for the defect in Sinus Venosus ASD (ASD 3)?
Near the junction of the superior vena cava (SVC) and the right atrium.
ASD s/sx
H-O-L-E-S
* HF & Pulmo HTN
* Often Respi Infection
* Low Growth & Weight
* Extra Heart Sound
* Stroke
What heart sound is often associated with ASD?
Systolic ejection murmurs.
What is the surgical treatment option for ASD?
Surgical treatment: open repair with cardiopulmonary bypass before school age
mam jez lecture PLACEMENT OF PATCH same with VSD
What important teaching should be provided to families regarding small ASD defects?
A: Small defects may spontaneously close, and regular follow-up is important.
What is the non-surgical intervention for closing an ASD?
A: The defect can be closed using devices during a cardiac catheterization procedure.
Why might surgical repair of ASD be preferred for some patients before they reach school age?
.
A: Surgical repair is often recommended to prevent long-term complications such as pulmonary hypertension
What should be included in nursing education for families about post-surgical care for ASD repair?
Provide information on monitoring for signs of infection, activity restrictions, and follow-up appointments after open repair surgery.
In patients with ASD, why should nurses be vigilant for signs of respiratory infections?
A: Frequent respiratory infections are common in ASD due to increased pulmonary blood flow, and they should be managed promptly to avoid complications.
H-heart failure & pulmonary HTN
O-often respi infection
L-low growth and weight
E-extra heart sound
S-stroke
main cause of Patent Ductus Arteriosus (PDA)
A: Failure of the fetal ductus arteriosus to close completely after birth.
direction of abnormal blood flow in Patent Ductus Arteriosus
Blood flows from the aorta back to the pulmonary artery and lungs.
How does PDA affect the left ventricle?
It increases the left ventricular workload.
DOC that stimulates closure of ductus in
premature infants and some newborns
prostaglandin Synthetase inhibitors such as INDOMETHACIN
What is a characteristic heart sound associated with PDA?
loud machine-like murmur.
Loud systolic murmur – VSD
Machinery like murmur – PDA
What signs of congestive heart failure (CHF) might be seen in a child with PDA?
A: Poor feeding, fatigue, splenomegaly, poor weight gain, tachypnea, and irritability.
DOC to close a Patent Ductus Arteriosus in premature infants or some newborns
INDOMETHACIN (prostaglandin inhibitors)
A: Ibuprofen or Indomethacin, which are prostaglandin inhibitors.
What are s/sx of Patent Ductus Arteriosus?
1.Cardiac
2.Heart Failure
3.Continous Machine-like murmur
4.Wide pulse pressure
5.Endocarditis
6.Activity Intolerance
7.Lungs
8.Low weight
What is a common non-surgical treatment option for PDA in premature infants?
A: Administration of prostaglandin synthetase inhibitors to stimulate closure of the ductus.
In PDA, does less than 5cm hole has effect?
naurr.
Anatomical defect in Coarctation of the Aorta?
A localized narrowing of the aorta
which can occur proximal to, at, or distal to the ductus arteriosus
Characteristic blood pressure finding in patients with Coarctation of the Aorta?
A: Elevated upper-body blood pressure, leading to symptoms like headache and vertigo.
HTN @ upper extremities
COA pathognomonic sign
- Bounding radial pulse
- Absent femoral pulse.
What common symptoms might result from Coarctation of the Aorta affecting circulation?
A: Epistaxis (nosebleeds), headache, fainting, and lower leg cramps.
What medical therapy is typically used to manage congestive heart failure symptoms in Coarctation of the Aorta?
Digoxin and diuretics are used to reduce the severity of congestive heart failure caused by hypertension.
To reduce the severity of the
congestive heart failure from hypertension
SURGICAL treatment- Coarctation of the Aorta
BALLOON ANGIOPLASTY
What surgical procedure is performed to correct Coarctation of the Aorta?
END-TO-END ANASTOMOSIS
narrowed portion of the aorta is removed, and the two ends are anastomos
What are some typical signs or symptoms related to the lower body in Coarctation of the Aorta?
A: Lower leg cramps and fainting due to decreased blood flow to the lower body.
What is the main anatomical defect in Pulmonary Stenosis?
Narrowing at the entrance to the pulmonary artery.
What is the extreme form of Pulmonary Stenosis called, where no blood flows to the lungs?
A: Pulmonary atresia, where there is total fusion of the commissures.
Common symptoms in newborns with severe Pulmonary Stenosis?
- Cyanosis
- signs of congestive heart failure (CHF).
mild Pulmonary Stenosis present?
may be asymptomatic.
surgical treatment - Pulmonary Stenosis
- infant
1. Valvuloplasty or TRANSVENTRICULAR VALVOTOMY - child
1. PULMONARY VALVOTOMY
What is the surgical treatment option for infants with Pulmonary Stenosis?
Transventricular valvotomy
What surgical procedure is commonly performed for** older children **with Pulmonary Stenosis?
Pulmonary valvotomy
Pulmonary Stenosis SURGICAL TREATMENT
SURGICAL TREATMENT
* In infants, transventricular valvotomy
* In children, pulmonary valvotomy
