Cardiac Flashcards
Gastrulation
cardiac development - the arrangement of the 3 germ layers
Heartbeat begins & blood pumping
at 22-23 days of life and begins pumping blood during week 4
Complete cardiac development
occurs at 6 weeks - disorders of this embryological age include transposition, dextrocardia
Maternal Diabetes and CHD
Diabetes prior to conception increases risk by 2-4x; Elevated insulin levels result in hypertrophic cardiac tissue,
common CHD: transposition, VSD, cardiomyopathy
Rubella and CMV r/t CHD
PDA, ASD, VSD
SLE r/t CHD
fetal and neonatal complete congenital heart block and dilated cardiomyopathy
Maternal influenza r/t CHD
Right ventricular outflow tract obstruction
Male infants more likely CHD
COA, aortic stenosis, TGV, hypoplastic left heart
premature infants r/t CHD
PDA, ASD, VSD
weak pulses
shock, myocardial failure, or left outflow obstructions
bounding pulses
cardiac runoff (surplus), aortic insufficiency, systemic to pulmonary shunts (left to right)
continuous bruit murmur over fontanelle and liver
AV malformation
CHD associated with Trisomy 21
AV Canal, VSD, PDA, ASD-1 and -2, TF
CHD associated with Trisomy 18 (Edwards syndrome)
VSD, polyvalvular disease, ASD, PDA
Trisomy 13 (patau’s syndome)
PDA, VSD, ASD, Coarctation, AS, PS
3 physiological states of CHD
- low cardiac output
- Congestive Heart failure
- Cyanosis
Low Cardiac Output
defect that obstructs flow of blood out of heart or when heart is unable to pump effectively
Management of Low Cardiac Output
Correct heart rate (increase)
fluid administration
correct acid base imbalance
Meds to improve heart function
Signs of Low Cardiac Output (8)
pale, mottled skin
decreased LOS
Decrease UOP
Cap Refil >3 seconds
hypoglycemia
metabolic acidosis
increased serum lactate
Weak pulses
Signs of CHF (8)
flaring
tachypnea
retractions
tachycardia
pulmonary edema
cool, clammy skin
diaphoresis
fatigue
Management of CHF
Meds (diuretics)
Limit fluid administration
Resp. Support
Improve Nutrition
Temperature Control
Congestive Heart Failure
occurs when there is a defect that causes an increase in blood to the lungs
Cyanosis (in relation to CHD)
When the defect causes a decrease in blood flow to the lungs
Differentiating Cyanosis (Respiratory or Cardiac)
Respiratory - cyanosis decreases with crying, improves with O2 admin, signs of resp. distress present
Cardiac - cyanosis increases with crying, doesn’t improve with O2 admin, tachypnea but no signs of distress