cardiology Flashcards
Fetal ECHO detection of disease
A fetal echo can diagnose CHD now as early as 16 to 18 weeks’ gestation, and as early as 10 weeks’ gestation if done via high-frequency transvaginal echocardiography.
It can also diagnose arrhythmias and hemodynamic changes to the fetal heart.
Antibiotic prophylaxis for prosthetic cardiac valve
Any patient with a prosthetic cardiac valve or prosthetic material used for cardiac valve repair should receive antibiotic prophylaxis prior to any dental procedures. Oral amoxicillin in a single dose 30-60 minutes before the scheduled procedure is the first-line agent for antibiotic prophylaxis.
Tetrology of Fallot
Tetralogy of Fallot (TOF) is a congenital heart defect that changes the normal flow of blood through the heart, causing decreased blood flow to the lungs and oxygen-poor blood flow to the body. This is a result of increasing obstruction of the right ventricular outflow tract. The etiology is unknown and symptoms include episodes of cyanosis and dyspnea. The severity of symptoms depends on the degree of right ventricular outflow obstruction and the presence of a PDA (which is not one of the four anatomic cardiac defects of TOF, but could also co-exist with this diagnosis).
When affected babies cry or have a bowel movement, they may develop a “ TET spell” where they turn very blue, have difficulty breathing, become limp, and will occasionally lose consciousness. Other symptoms may include heart murmurs, easy tiring upon feeding, and finger clubbing.
The four anatomic defects include:
Pulmonary valve stenosis
Right ventricular hypertrophy
An aorta that overrides the ventricular septum
Ventricular septal defect (VSD)
Coarctation of heart evaluation
four limb BPs, mean difference between upper and lower extremities should be 10 mmHg or less
What to treat with during a tet spell
hypercyanotic episodes:
cradled in a knee-chest position, soothed, and given oxygen and morphine sulfate subcutaneously until the spell subsides.
The knee-chest maneuver increases systemic vascular resistance, decreases right-to-left shunting, and increases pulmonary blood flow, hopefully alleviating symptoms. Morphine is given to reduce hyperpnea (reduces ventilatory drive). In extreme cases, anesthesia and ventilation may be necessary.
digoxin drug side effects and monitoring
digoxin may cause anorexia and nausea, weight loss, hypokalemia, and may increase urinary excretion of magnesium and calcium, patients taking digoxin should be counseled on the importance of increasing dietary potassium, as well as dietary magnesium and calcium, if warranted.
Hydralazine
Hydralazine is in a class of medications called direct vasodilators, and acts directly on the blood vessel walls, relaxing muscles to allow blood to flow more easily. They are reserved for patients with hypertension that is extremely difficult to control and are sometimes used to treat a hypertensive crisis.
pathologic murmur
Pansystolic
