UNIT 4 CARDIAC Flashcards
What is the normal flow of blood through the heart?
Blood comes from the superior/inferior vena cave—> right atrium—> tricuspid valve—> Right ventricle—> pulmonary valve—> pulmonary artery—> lungs—> pulmonary veins—-> left atrium—> mitral valve—> left ventricle—> aortic valve—> body
What is the only artery in the body w/deoxygenated blood
Pulmonary Artery
What is the only vein in the body that carries oxygen?
Pulmonary Vein
In a normal heart the pressure on the _____ is higher
Left
In a normal heart the pressure on the ____ side is lower
Right
Blood flow is going to depend on the….
Pressure… will go from higher pressure to lower pressure… and no flow = no grow
Aquired heart disease can result from
- Infection
- Autoimmune
- Environmental
- Famililar tendency
What are the causes of CHD?
Maternal
1. fetal alcohol syndrome, medication (dilantin/fenatoyin), illegal drugs, advanced maternal age, diabeties, infection, rubella
Chromosomal abnormalilties
1. Downs syndrome common to have ASD or VSD or both… AV canal also common
What will our physical assessent show in a cardiac potential?
- General appearance: No flow No grow
- Inspection:
- Nutritional state, color, chest deformities, Unusual pulsations, respiratory excursion, clubbing of fingers
- Palpations
- Abdomen, peripheral pulses
- Ausculation
- Heart rate and rhythm, characteristics of heart sounds
What diagnostic procedures might be used for cardiac problems?
- Electrocardiogram (ECG)
- Xray
- Echocardiogram
- Cardiac Cath
- Cardiac MRI
What can an EKG tell us?
12 lead EKG can tell us rate, any abnormal electrical conduction that they are having going on shows ischemia and ventricular hypertrophy.
What can a chest xray tell us? (cardiac)
Can detect cardiomegaly and pulmonary congestion.
What is the number one diagnostic exam for cardiac disorders?
Echocardiogram(ECHO)
1. Non-invasive and provides a good picture of blood flow pattern
2. Complication: Babies have to be still so may need sedation
Why would we use cardiac cath?
- Diagnostic purpose, measure pressures, inject dyes and see blood flow patterns
- Provides a really good picture as to whats going on prior to surgery
- Ballon procedure, stent… are procedures that can be done.
Why might we use electrophysiology?
Irregular rhythms— can go to the EP lab where they can stilulate different parts of the heart so that they can find the problem area
What are CHD that cause increased pulmonary blood flow?
- ASD
- VSD
- PDA
What causes increased pulmonary blood flow in the heart?
Defects along septum or abnormal connection between great arteries
- Left-to-right shunting of blood
- increased blood volume on the right side of heart
- increased pulmonary blood flow
What is ASD?
- Abnormal opening between the atria that allows blood flow from left atrium to right atrium
Symptoms of a small ASD?
May be asymptomatic
Symptoms of a large ASD?
- CHF unusal but possible: not really seen in children unless untreated
- Fatigue
- SOB
- Respiratory infections
ASD treatment includes?
- Spontaneous closure– depends on the defect and age of the child
- Transcatheter closure
- Septal occluders- smaller defects: best for smaller defects in the middle of the septum
- Low-dose aspirin for 6 months after to help prevent clot formation on foreign device
- Eventually tissue will grow over device.
- Surgical closure
- Smaller defects- sutures
- Mod to large defects use patch (pericardial or dacron)
When is surgical or trancather closure done for ASD?
Usually before they are school-aged.
What is VSD?
Abnormal opening between left and right bentricles that allows blood flow from left ventricle to right ventricle may vary in size from pinhole to the absence of the septum- common ventricle
Symptoms of small VSD defects include…
usually asymptomatic, no physical restrictions, reassurance and periodic follow up