Exam 3: Cardiac

Question 1

what are some Pediatric Indicators of Cardiac Dysfunction

Answer 1

Poor feeding
Tachypnea, tachycardia
Failure to thrive, poor weight gain, activity intolerance
Developmental delays
Positive prenatal history
Positive family history of cardiac disease

Question 2

what are the two types of cardiac defects?

Answer 2

congenital or acquired

Question 3

congenital cardiac defect?

Answer 3

anatomic, resulting in abnormal function (since birth)

Question 4

acquired cardiac defect?

Answer 4

Disease process: infection, autoimmune response, environmental response, familial tendencies

Question 5

what are some maternal/environmental causes of CHD?

Answer 5

if mother has rubella in the first 7 wks, chance of CHD is 50%

Question 6

what is the major cause of infant death?

Answer 6

CHD

Question 7

what is the most common anomaly of CHD?

Answer 7

ventricular septal defect

Question 8

blood flows form higher pressure on the left side ot lower pressure on

Answer 8

right side

Question 9

shunting from left side of heart

Answer 9

to right side –> through defect. which causes CHF

Question 10

what can be done for kids who have atrial septal defect?

Answer 10

surgical patch & cardiac cath & open heart surgery

Question 11

ventricular septal defect? what can be done for kids?

Answer 11

most common CHD. rt atrium can enlarge, HF, shunting is left to right, can be asymptomatic, daychron patch, systolic murmur is heard at left sternal border
large VSD: SOB, poor feeds,fatigue, and resp. infections. surgical open heart surgery
risk for: bacterial endocarditis or issues in pulmonary obstructive vascular disease.

Question 12

patent ductus arterious?

Answer 12

failure for ductus to close in first week of life. left aorta to right pulmonary artery. widened pulse pressure
PDA: machinery like murmur at left subclavicular margin. (hallmark sign) frequent colds, RSV,
-prostoglandin inhibitor (indomethocin)
-coils in ducts to keep it closed

Question 13

what are the three main obstructive defects?

Answer 13

Coarctation of the aorta

Aortic stenosis

Pulmonic stenosis

***blood exits heart, and meets area of narrowing or stenosis, causes blood flow obstruction. decrease in cardiac output

S/S of HF

Question 14

coarctation of aorta?

Answer 14

coarc- small narrowing on top. increase pressure in head and upper extremeties compared to lower.

S/S: high blood pressure and bounding pulses in arms, cool extremeties, lower extremeties BP is 10 less than upper extremeties. give digoxin.

• nonsurgical repair (angioplasty or stent) not permanent
• surgical (thoracotomy)

Question 15

aortic stenosis

Answer 15

-narrowing of aortic valve. left ventricular hypertrophy. hypertension. left vent.
chest pain, fatigue, exercise intolerance, dizziness when standing

-balloon angioplasty is best fix
bacterial endocarditis is risk for kids suffering from this

Question 16

pulmonic stenosis

Answer 16

narrowing at entrance to pulmonary artery. rt. vent. hypertrophy. may cause reopening of foramen ovale (which is good)
newborns: cyanosis, loud systolic murmur at SB, dyspnea at exercise, fever

• balloon angioplasty (risk for bacterial endocarditis)
• shunt blood from aorta to lungs

Question 17

decreased pulmonary flow defects types

Answer 17

Tetralogy of Fallot

Tricuspid Atresia

(there’s a pumonary issue AND anatomic issue (such as asd or vsd. increase pressure on rt. side of heart, due to diffcicuty of blood exiting. shunting is right to left!

hypoxia and cyanosis

Question 18

tetralogy of fallot

Answer 18

vsd, overriding aorta, pulm stenosis, and rt. vent hypertrophy. most common cyanotic defect.

Question 19

shunting with tetralogy of fallot

Answer 19

dependent on resistance between pulmonic or systemic.
if pulmonic is more resistant than systemic, shunting is right to left.
if systemic is more resistant then pumonic, then we’re shunting left to right

-left side of heart gets less oxygen
-cyanosis and hypoxia with crying, relief with squatting (tet spells)
systolic murmur
-seen more in morning. space out activities to prevent tet spells.
-risk for embolotic seizures
-surgery, close vsd, reset pulm. stenosis

Question 20

tricuspid atresia

Answer 20

tricuspid valve fails to develop
-no movement of blood
complete mixing of deox and oxy blood in left side
-severe cyanosis, dyspnea, tachycardia, clubbing of fingers
-prostoglandin E given to get blood circulating
-surgery–> shunt, anastomoses

Question 21

final group: mixed defects

Answer 21

fully saturated systemic blood mixes with desaturated pulm blood. resulting in desat. systemic blood flow. cyanosis and HF

Question 22

transposition of arteries

Answer 22

wrong side, backwards. no connection between systemic and pulmonary. blood does not mix.
cyanosis, poor feeds, tachy,

Question 23

truncus arteriosus

Answer 23

single vessel which overrides vessels. blood from right and left ventricle enter same vessel.

desat and hypoxemia

Question 24

total anomolous venous connection

Answer 24

pulm. blood flow from rt. atrium instead of left. atrium. enlargement, ASD, (rare)

Question 25

hypoplastic left heart syndrome

Answer 25

giant right ventricle. fatal if not fixed. small or none left ventricle (which pumps)