Week 6 pediatric Conditions Flashcards by Alexis Ross

Heart begins to develop at __________ during formation of the _________

3 weeks gestation; heart tube from the mesoderm

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The heart develops into 4 separate chambers

atria - week 4
ventricles - week 7

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Heart development is completed

8 ~ 10 weeks gestation

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Heartbeat starts

22-23 days

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Development of chambers and some vascular structures

23 days

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Blood circulation

27 days

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Aorta development

6 weeks

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Acyanotic

blood contains enough oxygen, but it’s pumped throughout the body abnormally

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Cyanotic

reduces the amount of oxygen delivered to the rest of the body

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Acyanotic diseases

ASD
PDA
VSD
Coarctation of the aorta

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Cyanotic diseases

Hypoplastic L heart syndrome
Truncus arteriosus
Tricuspid atresia
Transposition of the great arteries
Tetralogy of Fallot

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Arterial Septal Defect (ASD)

Foramen ovale is a hole between R and L atria that typically closes shortly after birth
The hole does not close

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ASD clinical presentation

heart murmur, pulmonary artery enlargement

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ASD can cause damage to pulmonary vasculature because

pressure is higher

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ASD treatment

surgical closure

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What is most common in all CHD

VSD

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Ventricular Septal Defect (VSD)

hole between walls of ventricles at the ventricular septum

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VSD can lead to

Cardiac infection, CHF, and respiratory infection

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VSD clinical presentation

restlessness, difficulty eating/feeding, inability to gain weight, tachypnea

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VSD treatment

may close over time but closure can be surgical after a certain age ~ 6 yrs

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Atriventricular Septal Defects (AVSD)

abnormal development of tricuspid and mitral valves, often with only one valve forming between sides of heart instead of 2

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AVSD often involves an

ASD and VSD - holes between walls of aorta and ventricle

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AVSD clinical presentation

symptoms of HF, decreased energy, slow to gain weight, poor feeding, heart murmur

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AVSD treatment

surgical, generally at 4-6 months

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Ductus arteriosus

a structure in the fetus that links blood flow between the pulmonary artery and descending aorta

Ductus arteriosus typically closes

5-14 days after birth if this doesn't close, blood may enter lungs

PDA is common in infants with

ARDS, Down's syndrome, or marfan syndrome

PDA clinical manifestations

respiratory distress, inability to gain weight, tachycardia

PDA treatment

surgical close or medication to increase the lipid that typically facilitates closing the PDA in neonates

Coarctation of the Aorta

narrowing of the aorta leading to hypertension in the head/UE and low pressures in the LE

Coarctation of the Aorta common presentations

HF, HTN

Coarctation of the Aorta S&S can develop within

first week after birth

Coarctation of the Aorta treatment

surgical (suture or stent)

Tetralogy of Fallot four parts

VSD Overriding aorta R ventricular hypertrophy Pulmonary stenosis

Tetralogy of fallot

Instead of blood from R side -> lungs and L side -> body, blood can cross hole between ventricles and less blood is pumped to lungs

Tetralogy of fallot presentation

cyanosis, hypoxia

Tetralogy of fallot treatment

surgical (shunt, complete repair)

Transposition of the great arteries

Aorta comes from R ventricle and pulmonary artery from L ventricle Because the arteries are connected to the wrong chambers of the heart, blood either bypasses lungs or bypasses systemic circulation

Transposition of the great arteries treatment

surgery (create PDA to allow for shunting of blood, move arteries to appropriate source, create tunnel between atria)

Transposition of the great arteries clinical presentation

impaired contractility, valve dysfunction, arrhythmias

Hypoplastic Left Heart Syndrome

Caused by decreased development of L side of heart: L ventricle, coarctation of the aorta, complete occlusion or stenosis of aortic/mitral valves

Hypoplastic Left Heart Syndrome presentation

HF symptoms, respiratory issues, cyanosis, tachycardia

Hypoplastic Left Heart Syndrome treatment

surgery (shunt, revision of aorta or pulmonary artery pathway), eventual heart transplant

Truncus Arteriosus

Aorta and pulmonary artery exist as one structure and not as separate structures causes oxygenated and deoxygenated blood to mix

Truncus artery is over the

VSD

VSD repaired with

patch, then pulmonary artery re-routed

Tricuspid Atresia

tricuspid valve does not form or is occluded/stenosed leads to decreased blood flow to R ventricle and to lungs for O2 exchange

Tricuspid atresia leads to

decreased volume/development of the R ventricle over time

Tricuspid atresia treatment

surgical (create a shunt, or allow blood flow between R atrium and pulmonary artery)

Tricuspid atresia may occur with

ASD

Tricuspid atresia presentation

cyanosis, difficulty breathing, fatigue, poor weight gain or feeding

Down's syndrome

ASD, VSD, Tetralogy of Fallot, AVSD May be caused by genetic or developmental factors

Marfan syndrome

Genetic connective tissue disorder Risk of aortic aneurysm or dissection

Fetal alcohol syndrome

ASD, VSD, PDA, Tetralogy of Fallot

Arthrogryposis multiplex congenita

Cardiomyopathy

with median sternotomy

may not be able to perform tummy time

patients with cyanotic defects may have

more restriction with physical activity than same-age peers with acyanotic defects

Patients with ASD, VSD, PFO (small or closed); PDA or TGA (post-op) can

participate in all sports

Pediatric journal indicates

60 min mod to vigorous activity daily is generally appropiate

Exercise more caution with those patients who have significant

ventricular disease or arrhythmia

Overarching goal

change daily behaviors and day-to-day physical activity