Cardiac Issues Flashcards
what is the number one birth defect?
congenital heart defects
- 0.8% of all children (1 in 150)
- most problems are minor and self limiting
- technology helps (18% dec in mortality)
what are congenital heart defects associated with?
- down syndrome
- inborn errors of metabolism (homocystinuria)
- connective tissue disorders
abnormal opening between the atria
atrial septal defect
- blood flows from R atrium to L atrium
- pulmonary blood flow inc (HTN)
is atrial septal defect symptomatic?
no, but can lead to:
- pulmonary HTN
- CHF
- atrial arrythmias
type of atrial septal defect in which there is a failure of the atrial septum to close during development
secundum
*80% of all ASD cases
type of atrial septal defect in which there is drainage of right pulmonary vein into right atrium instead of left
sinus venous type
type of atrial septal defect in which there is clefting of mitral valve and is commonly associated with DOWN SYNDROME (65% of down syndrome ppl have this)
ostium premium
type of atrial septal defect in which there is a coronary sinus (more RARE type of ASD)
coronary sinus septal defect
abnormal opening between the ventricles
ventricular septal defect
- MOST COMMON congenital cardiac lesion (15-30%)
- similar to having one venticle (“fontan circulation”)
is ventricular septal defect more common in males or females?
females
clinical significance of ventricular septal defect is directly related to what?
size of the defect
most common type of ventricular septal defect
perimembranous
ventricular septal defect near aortic valve as associatied with aortic valve prolapse
suprocrestal
type of ventricular septal defect that has spontaneous closure?
muscular singular
type of ventricular septal defect that resembles “swiss-cheese” and requires very complex surgical management
muscular multiple
failure of the ductus arteriosus to close after birth and leads to blood traveling form the aorta to pulmonary artery
patent ductus arteriosus
patent dectus arteriosus is initially what?
acyanotic (left to right)
- and then leads to cyanotic (right to left) if not treated
which gender is more likely to have patent ductus arteriosus
2:1 female
casued by abnormal location of the muscle that separates the aortic valve and the pulmonary valve and is the MOST COMMON cyanotic defect after 1 year old
tetralogy of fallot
which gender is more likely to have tetralogy of fallot
3:2 males
what are the 4 aspects of tetralogy of fallot?
- VSD: less oxygenated blood to body
- pulmonary stenosis: less blood to lungs
- R ventricle hypertrophy (inc work)
- transposition of the aorta: less oxygenated blood to body
what are some complications of kids with tetraology of fallot?
- pacemakers
- post-surgical arrythmias (bradycardia)
- residual post surgical defect
- fatigue/cyanosis
narrowing of the aorta that is often accompanied by aortic valve defects, typically where ductus arteriosus closes
coarctation of the aorta
what is often seen in coarctation of the aorta?
- upper body HTN
- lower body HYPOtension
what are the indications of pediatric heart transplant?
- life expectancy less than a year
- significant limitation on daily life
what are causes of end-stage heart disease in children?
- viral or idopathic cardiomyopathy
- severe congenital heart defects
how many pediatric heart transplants are done every year?
500
why is survival after a pediatric heart transplant greatly improved?
- advancements in PICU
- immunosuppression is more effective
- statins to reduce coronary disease
*survival approx at 90% at 3 years
is the epi in LA going to cause any issues to the cardiovascularly compromised?
no
what are some dental preventative practices for cardiovascularly compromised?
- OHI
- diet
- pt edu
- caretaker edu
what percentage of pts using cylosporins have gingival overgrowth? have cancer?
- 30-50%
- 50%
what is the normal prothrombin time?
12-13 seconds
what is the therapeutic range for INR?
2-4
*still high but local measures can be used to control bleeding
what are the ranges for INR?
high INR = 5 or greater (high chance of bleeding)
low INR = 0.5 (high chance of clotting)
normal INR = 0.9 - 1.3
what should you worry about with infective endocarditis?
- consult/ present findings to cardiologist
- NO SEDATION or GA without clearance
