ATI 20 - Congenital heart Disease - OBSTRUCTION TO SYSTEMIC BLOOD FLOW Flashcards
3 types of obstruction to systemic blood flow*
1 aortic stenosis
2 coarctation of aorta
3 hypoplastic left heart syndrome
AORTIC STENOSIS
**pathophysiology
narrowing of aortic valve> decr BF to systmc circ
-usually 2 instead of 3 leaflets
**LV works harder to force blood past narrow opening
AORTIC STENOSIS
***clinical manifestations
SBP higher in right arm than left
- systolc heart mrmr + thrill in aortic area
- —may transmit to neck
AORTIC STENOSIS
clinical therapy
PGE1
balloon dilatins via catherization
surgical valvotomy
AORTIC STENOSIS
**prognosis
chest pain, syncope, sudden death in symptoamic kids
**esp during vigorous exercise
-lifelong anticoag therapy
COARCTATION OF AORTA
**pathophysiology
narrowing/constriction of descending aorta
- *near DUCTUS ARTERIOSUS
- or new left subclavian artery
COARCTATION OF AORTA
**clinical manifestations
- *most asymptomatic + grow normally
* *lower BP + weaker pulse in legs
**newborns w severe coarctation of the aorta may develop…
- cyanosis in lower extremities
- HF
- shock as ductus arteriosus closes
—–renal + enerocolitis problems may occur
COARCTATION OF AORTA
**clinical therapy
clinical resection is preferred bc less risk for recoarctation
repair of defects recommended before 6 months
Hypoplastic Left Heart Syndrome
pathophysiology
mitral + aortic valves are absent or stenosed
abnormally small left ventricle + small aorta
Hypoplastic Left Heart Syndrome
**clinical manifestation
w/in hours after birth,
newborn has progressive cyanosis,
signs of CHF as ductus arteriosus closes
Hypoplastic Left Heart Syndrome
**clinical manifestation
- *PGE1 given immediately
- *NORWOOD surgery
- intubatn, ventltn, O2
- ophtal + neuro evals
- surgery or hrt transplant
Hypoplastic Left Heart Syndrome
**prognosis
- surgery needed for survival
- 50% of survivors have lots of cogntv + neuro impairment
