Cardiac Anomalies Flashcards
6 Cs of Cardiac Problems
{AKA the 6Cs of prenatal dx of cardiac dz}
Cyanosis Congestive Heart Failure Circulatory collapse Cardiac arrhythmias Cardiac murmur without symptoms Coincidental to workup of syndrome or other congenital defect.
6 Ts of Neonatal Cyanosis
Transposition of the Great Arteries
Tetrology of Fallot
Tricuspid or pulmonary atresia with hypoplastic right ventricle or single ventricle)
Total anomalous pulmonary venous return
Truncus arteriosus
Transitional circulation = persistent pulmonary hypertension
How to Dx after finding central cyanosis
ECHO!
(Chest X ray, ECG)
evaluate for surgery
CHF Causes
Severe tricuspid or pulmonic insufficiency Underdeveloped left ventricle Severe pulmonic or aortic stenosis Transposition of the Great Vessels (with shunt) Coarctation of the Aorta Anomalous pumonary vein drainage VSD, single ventricle Truncus arteriosus Patent ductus arteriosus AV canal defects (ostium primum etc )
CHF Treatment
reduce fluids, induce diuresis
indomethacin for premie with PDA
surgery for all else
Cardiovasc Collapse Sxs
Sudden onset of poor perfusion, mottling,
feeding difficulties and metabolic acidosis
tachypnea/resp distress, right ventricular heave pulse and blood pressure discrepancy in arm vs leg pale shocky
Cardiovasc Collapse Causes
Coarctation
Critical aortic valve stenosis
Hypoplastic left heart syndrome (aortic or mitral valve atresia with hypoplastic ventricle
Interruption of the aortic arch (stenosis, transposition)
Cardiovasc Collapse TX
Pg E1 infusion, stabilization of acidosis, surgery
Circumoral cyanosis
normal finding
bluish discoloration around the mouth which is associated with nipple or breast feeding and should resolve following the feeding
Central cyanosis
Abnormal.
may be visible even with 3-5 gm/dL reduction in Hb
Infants with polycythemia
may appear cyanotic even when even when adequately oxygenated
Infants with anemia
may not appear cyanotic even when hypoxic
q
If cyanosis is present, one must differentiate between peripheral and central cyanosis and whether it improves with crying, does not change or becomes worse with crying.
Palpate
Check for thrill PMI peripheral pulses check that pulses are symmetrical BL if pulses asymmetrical: 4 extremity BP. difference may be coarctation of aorta.
Situs invertus
organ arrangement reversed. Heart is otherwise normal.
Dx - heart sounds predominate on right. U/S
