Peds cardiac Emergencies Flashcards
Waht is Total anomalous venous return?
Pulmonary Veins cant get back to the Left Atriun/Ventricle.
Need a shunt before they leave the hospital.
What makes the major difference in history in TAPVR?
Whether or not there is a Venous obstruction present
What is the Surgical Management of TAPVR?
Reconnect pulmonary venous confluence to the back of the left atrium. Hard to do since everything is behind the heart!
What is the last Vital sign to change is Shock?
BP is the last to fall!
What are the ABCDEs of Resuscitation?
Airway Breathing Circulation Draw Labs -Blood Culture, blood gas, CBC, CMP -Inotropes, antibiotics, Na Bicarb Echocardiogram
What can cause Cardiogenic Shock at 5 days of age?
Ductus arteriosus closed
What are the possible causes of left sided Obstruction?
Critical Aortic Stenosis
Critical Coarctation of the Aorta
Hypoplastic Left Heart
What are the Effects of left sided Obstruction?
LV obstruction
LA Dilation
Pulm Venous Congestion
L to R shunt across atrial septum
Why should High O2 be avoided in Left sided obstruction?
Will cause pulmonary vasodilation
YOu want more blood in the systemic circulation, not the Lungs!!!
What are the causes of Right Sided Obstruction?
Pulmonary Atresia
Critical Pulmonary Stenosis
Tricuspid Atresia
What are the effects of Right Sided Obstruction?
Right atrial Dilation
Right sided Heart Failure
What is the immediate management of RSO?
PG E1 via continuous IV infusion
Inotropic Support
Correction of Metabolic Acidosis
What are The Definitive and palliative therapies in RSO?
Baloon/Surgical Valvuloplasty
Aorto-pulmonary Shunt
Blalock-Taussing
What are the causes of Inadequate mixing?
D Transpostion
Tricuspid Atresia + Restrictive ASD
Pulm Atresis + Restrictive ASD
HLHS + Restrictive ASD
What type of Tachycardia is most common in children?
Supraventricular Tachycardia
What are rhe Charicteristics of WPW on ECG?
Short PR interval
Delta wave
Slurred R wave
What are the Medical managements of SVT?
Increased vagal tone -Valsalva -Gag reflex -Ice to the forehead Related to patients age
What is Adenosine used for?
Blocks conduction through AV node
If this is unsuccessful or if unstable then use electricity
What are the Short Term and Long term Therapies for SVT?
Shock
Meds Beta Blocker Digoxin Ca Channel Blocker Amiodarone Ablation procedure
What is the Clinical Presentation of Complete Heart Block?
Thaerapy?
Bradycardia
CHF
Some asymptomatic
External pacing
implantable pacemaker
What is the cause of Muffledheart sound?
Pericardial effusion/Tamponade
What are the therapies for a Cardiac Tamponade?
Pericardiocentesis -needle or catheteter drainage of pericardial space Correct the problem -stop the bleed Anti inflammatory meds
What is a chylothorax?
Lymphatic fluid within the pleural space leaking from thoracic duct
Slow accumulation
Noonan syndrome
More common in complex, single ventricle lesions
What size tube is used for a B-T shunt in newborns?
3.5 mm diameter
What are the reasons for BT shunt obstructions?
Non-compliance with anti coagulation
Dehydration
Poor ventricular function
Elevated Pulmonary vascular resistance
