Heart Defects

Question 1

Congenital heart defects (only those covered in class)

Answer 1

-Classification: increased P blood flow, decreased P flow, obstruction to flow out of heart, mixed flow.
-Poor feeding is always a red flag in children
-In children (in general s/s): poor weight gain, tachycardia, activity intolerance, developmental delays, (+) family history of cardiac disease
-Also: chest deformities, poor weight gain, respiratory, clubbing, cyanosis

Question 2

Atrial Septal Defect

Answer 2

-Loud murmur detected
-Can be asymptomatic
-Hole in b/w the atriums
-The hole sometimes closes by itself
-Surgical patch closure for big defects
-Increased pulmonary blood flow
-Common cause of heart failure

Question 3

Ventricular Septal Defect

Answer 3

-Increased pulmonary blood flow
-Abnormal opening b/w ventricles
-The hole closes by itself most times
-Murmur
-Heart failure is common
-Procedure of choice

Question 4

Patent Ductus Arteriosis

Answer 4

-Increased pulmonary blood flow or + left-sided blood flow
-Asymptomatic or HF signs
-Loud murmur

Question 5

Obstruction to blood flow: Coarctation of Aorta

Answer 5

-Bounding arm pulses
-Faint pulse (lower ex.)
-High pressure (up), lower pressure (down)
-HF

Question 6

Teratology of Fallot

Answer 6

-Acute episodes of cyanosis/hypoxia (called blue spells)
-Elective repair
-Chance of seizures, loss of consciousness, emboli, or sudden death during blue spells

Question 7

Congestive Heart Failure

Answer 7

-The inability of the heart to pump an adequate amount of blood into circulation.

-Structural abnormalities.
-Right or left-sided heart failure.
-Manifestations: sweating, tachycardia, weakness, fatigue, pale & cool extremities, weight gain, hepatomegaly.

-Therapeutic Management: remove accumulated fluid w/ diuretics, and reduce cardiac demands, improve tissue oxy by providing humidified oxygen.

-Also: maintain nutritional status, med admin. to improve cardiac function, organize care for rest and decreased cardiac demands, assess position & admin oxy to reduce resp distress.

Question 8

Kawasaki Disease

Answer 8

-Lymph node syndrome.
-75% of cases younger than 5.
-Defer live vaccines after IVIG.
-EXTREME irritability (their body is on fire).
-IVIG vaccines reduce the chance of coronary artery issues.
-Aspirin for inflammation (usually not used for children unless it’s serious).