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210 Ped Ch. 48
cardio
| Question | Answer |
|---|---|
| 2 kinds of cardio dysfx | congenital heart disease(CHF, hypoxemia) Acquired Cardiac Disorders (Kawasaki Dis, Rheumatic Fever) |
| Inspection of infant w/ suspected cardiac dysfx | 1.nutritional state: wt/failure to thrive 2.color: cyanotic/pallor 3.clubbing(not infant) 4.pulsating neck vv |
| inspect abd? | abd: hepatomegaly/splenomegaly: indicates rt sided failure peripheral pulses: discrepancies chest: feel a thrill |
| pre=procedural cardiac catheterizations? post? | b4, get baseline VS/ht/wt/allergies/dorslis, post tibial pulse watch for hemorrhage post: same |
| CHD: congentital heart disease cause: | most common anomaly in VSD cause: mom drug use, rubella, toxoplasmosis, VSD, cardiomyopathy |
| circulation changes at birth | b4: pressure greatest on right after: pressure greatest on left |
| fetal circulation structures | foramen ovale: bn R/L atrium ductus arteriousus: bn aorta and pulmonary art ductus venosus: comes from umbilicus |
| Older classifications of CHD? Newer? | old: acyanotic/cyanotic new: hemodynamic considerations.... incr/decr pul flow, obstruction of flow out of heart, mixed flow |
| Defects that decr pulmonary blood flow? | abn connection bn 2 sides of heart, incr vol on Rside, incr pul flow, decr systemic flow ASD: atrial septum defect VSD: ventrical septum defect PDA: patent ductus arteriosus AVD: atrioventricular canal defect |
| ASD? | hole bn 2 atriums at septum, asymptomatic, more probs with athletes later, L-R shunt, R atria/vent distended, incr oxy blood into R atria then lungs, risk for emboli tx: nonsurgical patch |
| VSD? | L-R shunt, most common, can vary, R vent enlarged, incr blood flow to lungs, CHF common, risk of endocarditis tx: patch |
| Severe case of VSD? | Eisenmenger syndrome: resis in pulm flow > systemic circulation, so reverse flow in vent. tx: heart/lung transplant as adult |
| PDA? | ductus arteriosus not close, heart works harder to get blood to system tx: indomethosine: closes, antibiotics, (prostaglandin E keeps open) Dx: echo |
| s/s pda | bounding peripheral pulses, widened PP>25(bc losing resis out of heart cause losing vol so losing pressure), machinery murmur |
| AVD: | endocardial cushion defect, both septums open, so blood flows thru all 4 chambers, L-R shunting, hypertrophy on R side Most common in Down syndrome |
| Obstructive Defects: | block flow of blood out of heart, it's oxygenated Coarctation of Aorta Aortic stenosis Pulmonic stenosis |
| coarctation of aorta? | aorta is narrowed near ductus arteriosus, high bp, bounding pulses in arms/weak in femoral, cool lower extremities, back up in L side and lungs tx: balloon, post: HTN, if HTN, recurrence |
| Aortic Stenosis? | Narrow aortic valve, L side hypertrophy, Vfib? incr resis in L vent, decr CO, pul congestion/HTN, decr coronary perfusion, incr risk of MI |
| s/s os aortic stenosis in infant? child? | infant: decr co, faint pulses all over, hypotension, poor feeding, tachy, murmur child: excercise intolerance, chest pain, dizzy stand tx: balloon, sugical |
| Pulmonic stenosis? Severe? | pulmonic valve narrowed, R vent hypertrophy, decr pul flow tx: balloon, surgical severe: pul atresia-need PDA/prost E, shunt unoxy to L atrium-cyanotic |
| Decr pul flow defects | pul flow obstructed, have defect ASD/VSD, back up in R side, deoxy shunt R to L to syst, hypoxic Tetralogy of Fallot Tricuspid atresia |
| TET? | 4 things: VSD, pulmonic stenosis, overriding aorta, R vent hypertrophy, R-L shunting, TET spells, squatting/flex infant knees, risk of emboli tx: repair VSD/stenosis |
| Tricuspid Atresia | need prost E, no tricuspid valve, so no comm bn R atria/vent. ASD adn VSD formed tx: opening from atria to vent |
| Mixed Defects | deoxy in system, co decr, cyanosis Transposition of great vessels Total anamolous pul venous connection R/L Hypoplastic heart syndrome |
| Transposition of Great Vessels | pul a leave L vent/ aorta leave R vent, must have prost E for PDA or septal defect to allow oxy blood to system tx: surgical fix |
| Total Anomalous Pulmonary Venous Connection | rare, pul vv fail to join L atrium, and drain into R atrium, so mixed. Oxy blood not delivered, cyanotic early on tx: surgical: reconnect pul v to LA and close ASD |
| Truncus Arteriosus | blood ejected from L/R vent into common trunk mixing pul and syst blood |
| Hypoplastic Left Heart | L side underdeveloped, L vent small with aorta atresia, need Prost E, then blood go to R atrium/vent and out to pul aa, also aorta gets from PDA to give to sys tx: transplant |
Created by:
palmerag
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