cardiovascular part 4 (2) Flashcards
What is infection of the tissue lining the heart chambers
infective endocarditis
what conditions does infective endocarditis occur with?
Congenital heart disease, central Venus catheters, heart surgery, and IV drug abuse
what is the clinical therapy of infective endocarditis
IV antibiotics 4-8 weeks
When are prophylactic antibiotics indicated related to infective endocarditis in children
when they are at high risk. Prior to dental and invasive respiratory procedures
What’s in inflammatory connective tissue disorder following an infection by Group A beta hemolytic streptococci
rheumatic fever
What will dramatic fever cause long term damage to
heart valves and joints, brain, and skin
how long after the untreated streptococcal infection does rheumatic fever occur?
1-3 weeks
What are clinical manifestations of rheumatic fever
- carditis
- arthritis
- subcue nodules
- erythema marginatum (skin rash on trunk)
- syndenham chorea: aimless movements of the extremities and facial grimacing if the CNS is involved
What is aimless movements of the extremities and facial grimacing that occurs in rheumatic fever when the CNS is involved
syndenham chorea
hownis rheumatoc feve diagnosed?
presence of 2 or more major clinical manifestations; positive strep test and an elevated antistreptolysin-o titer
what is used to treat the streptococcal infection in rheumatic fever?
Antibiotics
What is used to treat mild to moderate carditis, fever, and arthritis in rheumatic fever
ASA
What is used to reduce inflammation with severe carditis in rheumatic fever?
Corticosteroids
in what case would you need to avoid giving aspirin for rheumatic fever in children?
If they had rye syndrome
what is an acute cerebral disorder that may cause permanent brain damage
rye syndrome
What syndrome has a link between using aspirin in illnesses involving influenza or varricella
rye syndrome
What can prevent rheumatic fever
- throat culture with sore throat
- Entire course of antibiotics
- Daily low dose antibiotic or monthly long acting antibiotic injection to prevent future infection
- long term Cardiology follow up
what is an acute febrile systemic vascular inflammatory illness of unknown cause
kawasaki disease
what is the leading acquired heart disease in children
kawasaki disease
What arteries does kawasaki disease involve
small and midsize arteries, including coronary arteries
manifestations of kawasaki disease
- high fever longer than 5 days
- conjunctival hyperemis (redness)
- red, dry, cracked lips/tongue
- red swollen palms
- maculo papular rash trunk/perineum
- cervical lymphadenopathy
- diarrhea, irritable, hepatic dysfunction
how is kawasaki disease diagnosed?
Through clinical manifestations, echo used to determine heart involvement
What is used within 7 to 10 days of Kawasaki disease diagnosis to reduce the risk of coronary artery aneurysm
IV Immune globulin
How long is aspirin used for kawasaki disease
high dose used initially and then decreased to a low dose until platelet count is normal or long term cardiac abnormalities
How long have a patient be carefully monitored for cardiac disease after having kawasaki disease
up to 2 years
what is the most common pathologic tachycardia
supraventricular tachycardia (SVT)
what is an abrupt answer of regular rapid heart rate, too fast to count
supraventricular tachycardia (SVT)
What heart rate classifies supraventricular tachycardia in infants
> 220 bpm
what heart rate classifies supraventricular tachycardia in older children?
> 180 bpm
Is it common to have recurrent attacks of supraventricular tachycardia?
yeah
When is supraventricular tachycardia episodes life threatening
when they are prolonged
What are early infant clinical manifestations of supraventricular tachycardia?
Poor feeding, irritability, pallor
what are clinical manifestations of supraventricular tachycardia in older children?
Palpitations, chest pain, dizziness, shortness of breath, exercise intolerance, and syncopy
what is the clinical therapy for supraventricular tachycardia?
vagal maneuvers; synchronized cardioversion; oral medications; radiofrequency ablation (during cardiac catch, stimulates heart)
What vagal maneuver is used to stabilize cardiac output in infants with supraventricular tachycardia?
ice to face
What vagal open maneuver is used to stabilize cardiac output in older children with supraventricular tachycardia?
Blow through close nose, bear downness of having a bowel movement
what medicines are used if vagal maneuvers are unsuccessful or if cardiac output is unstable in supraventricular tachycardia
IV adenosine or propanolol
what converts supraventricular tachycardia when cardiovascular assessment is unstable?
Synchronize cardioversion
What is when the heart rate is less than the lower limit of normal for the child’s age?
Bradycardia
What is Bradycardia associated with?
Poor systemic profusion
what are clinical manifestations of bradycardia
fatigue, exercise intolerance, dizziness, syncopy
What is when one or more lipids have an abnormal level in the blood?
dyslipidemia
What disease can dislipidemia lead to in adulthood?
coronary heart disease
What is when systolic or diastolic blood pressure reading is equal to or greater than the 95th percentile for age, gender, and height
hypertension
what is defined as a systolic or diastolic reading that falls below the 90th percentile for age, gender, and height
normal bp
how is hypertension diagnosed?
Based on three separate readings a weaker part or ambulatory blood pressure monitoring when this hystolic or diastolic reading is greater than or equal to the 95th percentile for gender, age, and height
What percent of the circumference of the upper arm should the bladder cuff width be?
40%
When the cuff is wrapped around the upper arm, how much of the arms circumference should be covered by the bladder length?
80-100
What limb should be used for blood pressure?
Upper right arm
rheumatic fever is a result of what type of untreated infection?
Group a beta hemolytic streptococci throat
Infective endocarditis is an infection of the?
Endocardium
What may be used to stop supraventricular tachycardia? Choose all
1. cardioversion
2. vagal maneuvers
3. adenosine
4. defibrillation
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