Exam 3: Cardiac Flashcards
what are some Pediatric Indicators of Cardiac Dysfunction
Poor feeding
Tachypnea, tachycardia
Failure to thrive, poor weight gain, activity intolerance
Developmental delays
Positive prenatal history
Positive family history of cardiac disease
what are the two types of cardiac defects?
congenital or acquired
congenital cardiac defect?
anatomic, resulting in abnormal function (since birth)
acquired cardiac defect?
Disease process: infection, autoimmune response, environmental response, familial tendencies
what are some maternal/environmental causes of CHD?
if mother has rubella in the first 7 wks, chance of CHD is 50%
what is the major cause of infant death?
CHD
what is the most common anomaly of CHD?
ventricular septal defect
blood flows form higher pressure on the left side ot lower pressure on
right side
shunting from left side of heart
to right side –> through defect. which causes CHF
what can be done for kids who have atrial septal defect?
surgical patch & cardiac cath & open heart surgery
ventricular septal defect? what can be done for kids?
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.
patent ductus arterious?
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
what are the three main obstructive defects?
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
coarctation of aorta?
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)
aortic stenosis
-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
pulmonic stenosis
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
decreased pulmonary flow defects types
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
tetralogy of fallot
vsd, overriding aorta, pulm stenosis, and rt. vent hypertrophy. most common cyanotic defect.
shunting with tetralogy of fallot
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
tricuspid atresia
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
final group: mixed defects
fully saturated systemic blood mixes with desaturated pulm blood. resulting in desat. systemic blood flow. cyanosis and HF
transposition of arteries
wrong side, backwards. no connection between systemic and pulmonary. blood does not mix.
cyanosis, poor feeds, tachy,
truncus arteriosus
single vessel which overrides vessels. blood from right and left ventricle enter same vessel.
desat and hypoxemia
total anomolous venous connection
pulm. blood flow from rt. atrium instead of left. atrium. enlargement, ASD, (rare)
