Cardiopulmonary Dysfunction

Question 1

Congenital Heart Disease (DX) - changes at birth

Answer 1

• cardiovascular changes that occur at birth: the foramen ovale (hole b/w the R and L atria) must close; the ductus arteriosus closes and allows blood flow to the lungs; the ductus venosus closes to allow blood flow to the liver
• 3 categories of heart defects that increase pulmonary blood flow: 1) patent ductus arteriosus: most common condition found in preemies; can lead to heart failure and inadequate oxygenation of the brain; 2) atrial septal deficits: opening in the septum between the R and L atrial chambers results in “wet lungs” and may lead to respiratory infection; may cause R ventricle to work too hard and lead to heart failure; may result in poor exercise tolerance and being small for chronological age; 3) ventircular septal deficits: one or more openings in the muscular or membranous portion of the ventricular septum; more than 50% of cases self-resolve by age 5 but otherwise warrant surgery; could result in Eisenmenger’s complex or pulmonary vascular obstruction

Question 2

Congenital Heart Disease (OT)

Answer 2

• kids whose condition has not resolved or been treated surgically are likely to have compromised endurance but may develop typically unless a co-morbid condition is present
• pace activities appropriately
• select activities with care
• educate the kid and family about general health maintenance, including diet, exercise, and avoidance of smoke inhalation

Question 3

Eisenmenger’s Complex or Pulmonary Vascular Obstruction

Answer 3

• result of prolonged exposure to INcreased blood flow and high pressure (from ventricular septal deficits and 1+ opening(s) in the muscular or membranous portions of the ventricular septum)
• symptoms include feeding difficulties, shortness of breath, increased perspiration, increased respiratory infections, fatigue with increased activity, and delayed growth

Question 4

Congenital Heart Disease (DX) - Patent Ductus Arteriosus

Answer 4

• heart defect that INcreases pulmonary blood flow
• most common condition found in preemies
• can lead to heart failure and inadequate oxygenation of the brain

Question 5

Congenital Heart Disease (DX) - Atrial Septal Deficits

Answer 5

• heart defect that INcreases pulmonary blood flow
• opening in the septum between the R and L atrial chambers results in “wet lungs” and may lead to respiratory infection
• may cause R ventricle to work too hard and lead to heart failure
• may result in poor exercise tolerance and being small for chronological age

Question 6

Congenital Heart Disease (DX) - Ventricular Septal Deficits

Answer 6

• heart defect that INcreases pulmonary blood flow
• one or more openings in the muscular or membranous portion of the ventricular septum
• more than 50% of cases self-resolve by age 5 but otherwise warrant surgery
• could result in Eisenmenger’s complex or pulmonary vascular obstruction

Question 7

Congenital Heart Disease (DX) - Tetralogy of Fallot

Answer 7

• heart defect that DEcreases pulmonary blood flow
• characterized by pulmonary valve or arterial stenosis, a ventricular septal deficit, right ventrical hypertrophy, and override of the ventricular septum
• symptoms: central cyanosis, coagulation defects, clubbing of fingers and toes, feeding difficulties, failure to thrive, dyspnea

Question 8

Congenital Heart Disease (DX) - Transposition of Great Arteries

Answer 8

• heart defect with MIXED pulmonary blood flow
• characterized by no communication between the systemic and pulmonary circulations
• result of coexisting congenital transposition of the ventricles
• symptoms: cyanosis, congestive heart failure, respiratory distress