Management of CHD Flashcards
Why are you pink (4 reasons)
Normal CNS function
Blue blood goes to lungs to get oxygenated
Normal lung function (gas exchange needs to happen)
Heart has to be able to pump blood
Why are you blue (2)
Blue blood bypasses the lungs and goes to the systemic circulation
Poor gas exchange in the lungs
What should you see on and ECG for
- Lead 1
- aVF
- aVL
- Up
- Up
- Down
What is heart failure?
Clinical syndrome characterized by symptoms resulting from heart disease
Condition where the heart does not meet the metabolic needs of the patient
How does
1. High output failure
2. Low output failure
present?
- Presents as poor growth (like a AVSD)
2. Presents as poor perfusion (can be from obstruction or LV muscle failure)
3 types of heart failure
High output failure
Low output failure
LV dysfunction (systolic or diastolic)
Left to right shunt
Blood from high pressure side into low pressure side
Patients are pink because you recirculate red blood
Right to left shunt
Obstruction of pulmonary artery so blood goes into left heart
Patients are blue with low sats
2 most important objectives in the management of an infant/child with shunt physiology
Optimize growth and nutrition
Ensure developmental milestones
2 medications for a child who is breathing fast
Child is breathing fast because of the high bloodflow through lungs and resulting pulmonary edema
Diuretics (get rid of some of the fluid)
Digoxin
How to treat slow weight gain
Additional calories
NG feeds
3 simple tests to answer why a child is blue, and 1 more that is the most helpful
Hyperoxic test (give O2 - if he improves its a lung problem)
CXR
Electrocardiogram
THEN you can do an echo
2 main causes of cyanotic heart disease
Transposition physiology
Right to left shunt
Prostaglandin E1
Used to keep the ductus arteriosus open
Critical for some babies to allow for oxygenated blood to get to system
Hypoplastic left heart syndrome
Left side does not develop properly
Basically no lumen in LV
