Exam 2 Blueprint Cardiac Flashcards
What are the mixed defects?
Transpositional of the great vessels (TGV), total anomalous pulmonary venous return (TAPVR), Truncus arteriosus, and hypoplastic L heart syndrome (HLHS)
what is important to know about mixed defects?
Survival depends on mixing of blood from the pulmonary and systemic circulation within the heart, variable S/S depending on defect, cyanosis (although not always visible), CHF, and may require multiple surgeries (many times in the 1st week of life)
what is TGV?
the Aorta exits off the R ventricle and the pulmonary artery off the L ventricle, no communication between the pulmonary and systemic circulations, incompatible with life unless another defect is present that allows the mixing of blood, rapid and sustained cyanosis, surgical repair (immediate), and IV prostaglandin E may be admin to maintain ductal patency until surgery (to force the PDA and ASD to stay open)
what is TAPVR?
R atrium receives all the blood that normally would flow into the L atrium, R side of the heart hypertrophies, is overworked, and may cause a backup of blood in the lungs, L side of the heart, especially the L atrium, may remain small, generally have other defects, such as ASD or PDA, that will help the child by allowing more blood to get from the R side of the heart to the L side and out to the body, and if no other defects, immediate and progressive cyanosis and immediate surgical repair.
what is Truncus arteriosus?
during fetal development, failure of the pulmonary artery and aorta to divide, resulting in one single vessel that opens into both R and L ventricles. Resistance is less to pulmonary blood flow than to systemic blood flow, so more blood flow to the lungs. Moderate to severe CHF with variable cyanosis. Surgical repair in the 1st month of life, VSD is usually repaired 1st.
what is HLHS?
second most common CHD, severe underdevelopment of the L side of the heart, aortic valve, aorta, L ventricle, and mitral valve. Pulmonary congestion and edema. Child will be asymptomatic until ductus arteriosus closes, then poor perfusion with cyanosis, tachypnea, and dyspnea. IV prostaglandin E to keep ductus arteriosus open until taken to surgery.
what are the obstructive defects?
Coarctation of the aorta
Aortic stenosis
Pulmonic stenosis
infection of valves and inner lining
bacterial endocarditis
what is important to know about bacterial endocarditis?
Sequalae of bacteremia
Strep Viridians
Low grade, intermittent fever, malaise, arthralgias, new murmur
Increased ESR, vegetation on ECHO
TX: Penicillin
Prevention: give ABX b4 dentistry/procedures and TEACH!
inflammatory disease of the heart, joints, skin, and CNS
rheumatic fever
what is important to know about rheumatic fever?
Group B hemolytic strep (+ ASO)
Aschoff bodies: the lesions of rheumatic fever found around blood vessels in the myocardium
Mitral valve carditis, murmur, CHF possible
Polyarthritis
Rash: erythema marginatum (trunk/ext)
SubQ nodules
Chorea
TX: prevention of strep, cardiac damage prevention, recurrence prevention, and PenG
what is Kawasaki Disease?
systemic vasculitis, ectasia (dilation of coronary artery leads to aneurysm (giant)), S/S = high fever, red eyes, ring around iris, strawberry tongue, rash (desquamates), and serious = MI, TX = high dose IVIG and salicylate therapy, and NC: grumpy kids, symptomatic, supportive.
what have increased pulmonary blood flow?
ASD (atrial), VSD (ventricle), PDA, and AV canal
what is patent ductus arteriosus?
fetal duct between the pulmonary artery and the aorta fails to close. May have no symptoms, but a murmur may be heard, and the child may develop CHF. May close spontaneously, if not, it may be closed medically with the admin of Indomethacin (Indocin), a prostaglandin inhibitor. If med is unsuccessful, surgery may be needed.
what is atrial septal defect (ASD)?
hole between the atria. May be a foramen ovule that has not closed at birth or a defect unrelated to the fetal duct. Most have no symptoms, but may develop CHF, if the ASD is large. A murmur may be heard. May ASDs close spontaneously. If not, surgery or interventional cardiology may be performed.
