Pediatric cardio Flashcards
what are the two small openings between the left and right sides of the heart
Ductus arteriosus(DA), Foramen ovale. (FO)
Foramen oval (FO) function
Blood then passes through FO to the left atrium and then to the left ventricle and out the aorta.
Where does most oxygenated blood in the fetus go?
Most oxygenated blood goes to brain
Fetal hemoglobin (HgbF) has greater or smaller affinity for oxygen than maternal blood
greater. Hemoglobin concentration of fetus is high
Congenital Defects in infants
Occurring at birth or failure of normal development of cardiovascular system
Usually abnormal opening between adjacent heart chambers
Congenital Defects in infants causes
Viral infection, hereditary, Down Syndrome, Teratogens
APGAR Score
The 1-minute score determines how well the baby tolerated the birthing process. The 5-minute score tells the doctor how well the baby is doing outside the mother’s womb. Normal is 7 or above. A score of 10 is unusual
Shunting
Left to Right (acyanotic)
Right to left shunt (cyanotic)
Left to Right (acyanotic)
Arterial Septal Defect (ASD)
Patent Ductus Arteriosum (PDA)
Ventricular Septal Defect (VSD)
Right to left shunt (cyanotic)
Transposition of great vessels
Tricuspid atresia
Tetralogy of Fallot
Total anomalous pulmonary venous return
Patent Ductus Arteriosus (PDA)
when the DA doesn’t close
PDA creates Left to right shunt
(Aorta to Pulmonary Artery)
Creates high pressure in pulm. art.
Patent Ductus Arteriosus (PDA) might lead to
Increased ventricular work
Possible heart failure
Pneumonia
Atrial Septal Defects (ASD)
Blood flow between the atria
Forms a left to right shunt
Atrial Septal Defects (ASD) might lead to
May result in R heart failure
Ventral Septal Defects (VSD)
It involves a hole in the wall between the heart’s lower chambers.
Most common congenital heart defect is ventral septal defect (VSD)
Forms left to right shunt
Eisenmenger’s syndrome
cyanotic problem
If pressures in right ventricle become too high, blood can shunt right to left
Ventral Septal Defects (VSD) might lead to
Large defects can result in increased pressure in pulm artery,
Coarctation of the Aorta
Usually distal to subclavian artery
May be due to abnormal involution of Ductus Arteriosus
Severity dependent on degree of pinching and location
Present in 15-20% of CHD cases
Kidneys see low BP and release substances to increase BP
Triscuspid Atresia
Triscuspid valve fails to develop
Limited blood flow from RA to RV, Underdeveloped RV
Right to left shunt
Surgery Required
Pulmonary Valve Atresia
Pulmonary valve fails to develop
No exit from the right ventricle
Blood regurgitates into the left atrium via the foramen ovale
The lungs get perfused retrograde flow via a wide PDA
Tetralogy of Fallot
Tetralogy of Fallot is made up of four defects:
VSD
Pulmonary Valve Stenosis
Overriding Aorta (usually lies over VSD)
RV Hypertophy (due to PV Stenosis)
Blueness appears soon after birth, in infancy or childhood
Transposition of the Great Vessels
Positions of Pulmonary Artery and aorta reversed
Deoxygenated blood from RV goes into systemic circuit
O2 from blood goes back into lung
Hypoplastic Left Heart Syndrome (HLHS)
Failure or inadequate development of the left ventricle.
Variable aortic & mitral involvement
Child is dependent upon a PDA for systemic perfusion.
Without intervention, HLHS is fatal within the first weeks of life
Total Anomalous Pulmonary Venous Return (TAPVR)
Pulmonary veins don’t connect to the left atrium.
Supracardiac, Cardiac or Infracardiac
Child will require surgery soon after birth, considered a critical congenital heart defect.
Supracardiac (TAPVR)
In this type of TAPVR, a mixture of oxygen-poor and oxygen-rich blood returns to the right atrium through the superior vena cava.
Cardiac (TAPVR)
TAPVR, the pulmonary veins meet behind the heart and connect to the right atrium. The coronary sinus connects the pulmonary veins to the right atrium in this type of TAPVR.
Infracardiac (TAPVR)
A mixture of oxygen-poor blood and oxygen-rich blood returns to the right atrium from the veins of the liver and the inferior vena cava,
Extracorporeal Membrane Oxygenation (ECMO)
Support cardiac and respiratory systems until disease process resolves
ECMO is used for longer-term support ranging from 3-10 days
Norwood Procedure
Surgeons create a “new” aorta and connect it to the right ventricle
The heart then becomes a “single ventricle” structure capable of pumping mixed blood to lungs and periphery.
Arterial oxygen saturation following procedure 70-75%
Bi-directional Glenn Shunt Procedure
Creates a direct connection between the pulmonary artery and thesuperior vena cava.
Directly returns venous blood to lungs, from UE.
Fontan Procedure
Doctors now connect the pulmonary artery to theinferior vena cava.
Now venous blood completely bypasses the right ventricle
Once this procedure is complete, oxygen-rich and oxygen-poor blood no longer mix in the heart and the infant’s skin will be cyanotic.
