Cyanotic Heart Flashcards
What is Acrocyanosis?
Blue hands and feet
Not Pathologic
What Pathologies will show a V/Q Mismatch?
Pneumonia
Cystic Fibrosis
Hyaline Membrane Disease
How can you tell if it is the heart or the lungs involved?
Lung problem will respond to high flow O2
Heart problem will not.
What is Prostaglandin E1 used for?
Continuous infusion maintains patency of Ductus Arteriosus
What is done to Stabilize the Infant with CHD?
Temp Reg Labs Fluids O2 Ventilation Avoid acidosis Inotropic Support of Circulation
What are the 5 Ts of Cyanotic Heart Defects?
Truncus Arteriosus Transposition of Great arteries Tricuspid Atresia Tetrology of Fallot Total Anomalous pulmonary venous return
What is Transposition of Great arteries
LV connected to Pulm Arteries
RV connected to Aorta
Not conducive to life! Shunt!
Need to find a way to mix the two circulations for survival
What are PE findings in D-Transposition?
Cyanotic Tachypnic infant
S2 is single and loud
Heart murmur
Hepatomegaly
What is the Med Management of D Trans?
Prostaglandin Correct Acidosis O2 for severe hypoxia Baloon atrial Septostomy Anti Congestive Meds
What is the Rashkind Procedure?
Baloon Atrial Septostomy
Catheter with baloon inserted in jerked back to widen the Atrial Septal defect
What is the Atrial Switch Operation?
Connect the BVs to the Atria that are doing the correct job.
RV goes to Circulation,
LV goes to Lungs
What is the ARTERIAL Switch Operation?
Move the Coronary arteries over to the Left side so it has the capability to support the systemic circulation.
What is the Tetrology of Fallot?
1) Large VSD
2) Overriding Aorta
3) RV outflow obstruction
4) RV hypertrophy
Blood flows more readily through the VSD bc of Stenosis of Pulmonary outflow tract.
What is the natural history of the Tetrology of Fallot?
Gradually worsening Cyanosis
Hypoxic Spells
Growth retardation if severe
How are Hypoxic Spells managed in Tet of Fallot?
Hold infant in knee-chest position
O2
Morphine
Sodium Bicarb to treat acidosis
What are the Medical and Surgical Tx of Tetrolog of Fallot?
Medical: Eduaction about Tet spells
Surgical: Palliation with Blalock Taussing shunt
Patch to increase size of RV outflow tract
What is the Repair Technique for Tet of Fallot?
VSD closed and Pulmonic artery Opened with a patch
What is Tricuspid Atresia?
TC valve is absent RV is Hypoplastic Pulm Atresia or Pulm Stenosis Small VSD Is a reason for far left axis shift
What is the management of Tricuspid atresia?
Wont survive without surgery
Prostaglandin and Blaylock-Taussing Shunt
Waht is the Fontan Circulation?
Only one Ventricle
Connect IVC to Solo atrium and Pulmonary circulaton
Connect the Ventricle to the Aorta
What is the Truncus Arteriosus?
A single arterial trunk leaves the heart to give rise to the Pulmonary, Stystemic, and Coronary bloodflow
Lungs have very high flow and surgical intervention needed
as long as PVR
What is the Surgical Repair of Truncus arteriosus?
Direct LV flow out of the truncal valve via patch closure of VSD
Dissconnect Branch Pulm arteries from truncus and atach to RV-PA conduit
