This document provides information on various congenital and acquired cardiac defects including their symptoms, diagnoses, and treatments. It discusses defects that cause increased, decreased, or obstructed pulmonary blood flow such as VSDs, Tetralogy of Fallot, and pulmonary stenosis. Normal ranges are given for electrolytes and CBC components. Acquired defects like Kawasaki disease, endocarditis, and rheumatic fever are described along with their typical presentations and management. Symptoms of congestive heart failure and conditions like polycythemia and clubbing are also outlined.
This document provides information on various congenital and acquired cardiac defects including their symptoms, diagnoses, and treatments. It discusses defects that cause increased, decreased, or obstructed pulmonary blood flow such as VSDs, Tetralogy of Fallot, and pulmonary stenosis. Normal ranges are given for electrolytes and CBC components. Acquired defects like Kawasaki disease, endocarditis, and rheumatic fever are described along with their typical presentations and management. Symptoms of congestive heart failure and conditions like polycythemia and clubbing are also outlined.
This document provides information on various congenital and acquired cardiac defects including their symptoms, diagnoses, and treatments. It discusses defects that cause increased, decreased, or obstructed pulmonary blood flow such as VSDs, Tetralogy of Fallot, and pulmonary stenosis. Normal ranges are given for electrolytes and CBC components. Acquired defects like Kawasaki disease, endocarditis, and rheumatic fever are described along with their typical presentations and management. Symptoms of congestive heart failure and conditions like polycythemia and clubbing are also outlined.
This document provides information on various congenital and acquired cardiac defects including their symptoms, diagnoses, and treatments. It discusses defects that cause increased, decreased, or obstructed pulmonary blood flow such as VSDs, Tetralogy of Fallot, and pulmonary stenosis. Normal ranges are given for electrolytes and CBC components. Acquired defects like Kawasaki disease, endocarditis, and rheumatic fever are described along with their typical presentations and management. Symptoms of congestive heart failure and conditions like polycythemia and clubbing are also outlined.
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Quiz Blessings #5
Which cardiac defects are increased pulmonary flow, decreased pulmonary flow, and obstructive? Acyanotic Increased Pulmonary Blood Flow Defects ASD: opening in atrial septum that permits left-to-right shunting of blood o Very common as well o Loud murmur o Closure may be spontaneous or require surgery o Prognosis is good VSD: opening in ventricular septum permits left-to-right shunting of blood o Most common heart defect o Loud murmur o Small VSDs may close spontaneously or surgery o High risk if needed to be fixed in first few months of life PDA: persistent fetal circulation – very common in preterm infants o Can be closed with indomethacin or ibuprofen IV, devices, or surgery o Murmur is loud machine hum o Prognosis is good Obstructive Defects Coarctation of the Aorta: aorta narrows, usually near the ductus, obstructing o Blood pressure is usually higher in arms than in legs o Weak femoral or pedal pulses o Dilate with balloon or surgical repair o Persistent hypertension is common Aortic Stenosis: narrowing of the aortic valve o Dilate with balloon, surgical valvuloplasty, or valve replacement o May need repeated valve replacements or dilations as child grows Pulmonary Stenosis: narrowing of pulmonary valve o Second most common heart defect o Dilate with balloon or surgical valvotomy Cyanotic Decreased Pulmonary Blood Flow Defects Tetralogy of Fallot: four defects: pulmonary stenosis, right ventricular hypertrophy, VSD, overriding aorta (aorta receives blood from RV and LV o Right to left shunt occurs o To repair, need PDA, open FA, or ASD until surgery o The prognosis is improved quality of life, but may have ventricular dysfunction o Children with Tet usually squat to help relieve rapid drops in O2 Tricuspid Atresia: right side of heart or tricuspid valve is not developed o PDA provides blood to pulmonary artery and foramen ovale provides blood to left side of heart o Give prostaglandin to keep PDA open o Surgery is needed o Cannot create a tricuspid valve, so a different path is formed o Right ventricular dysfunction is common
Know basic lab values for electrolytes and CBC.
Electrolytes Sodium: 135-145 mEq/L Potassium 3.5-5.3 mEq/L Calcium: 9-11 mg/dL Magnesium: 1.8-3 mg/dL Phosphorus: 2.5-4.5 mg/dL CBC RBC o Females: 4.2-5.4 million/uL o Males: 4.7-6.1 million/uL WBC: 5000-10,000 Platelets: 150,000-400,000 Hemoglobin o Females: 12-16 g/dL o Males: 14-18 g/dL Hematocrit o Females: 37-47% o Males: 42-52% Acquired defects- Kawasaki, endocarditis, and rheumatic fever- what is it, signs and symptoms, common ages, interventions Kawasaki: acute systemic vasculitis of unknown cause. Inflammation of the arterioles, venules, and capillaries is evident and may result in coronary artery aneurysms o Child must have fever for more than 5 days along with 4-5 clinical criteria Changes in the extremities: erythema of palms and soles as well as peeling of the hands and feet Bilateral conjunctival inflammation without exudation Changes in the oral mucous membranes, such as erythema of the lips, oropharyngeal reddening or “strawberry tongue” Polymorphous rash Cervical lymphadenopathy (one lymph node >1.5 cm) o ECGs are necessary to assess for myocardial infarction o IVIG (intravenous immunoglobulin) along with salicylates to reduce coronary artery abnormalities and reduce inflammation o Monitor cardiac status o Minimize discomfort o Provide a quiet environment o aspirin Endocarditis: an infection of the inner lining of the heart (endocardium), which generally involves the valves o Usually occurs in children with congenital anomalies of the heart o s/s: onset usually insidious, unexplained fever, anorexia, malaise, weight loss, HF may be present, cardiac dysrhythmias, new/change in existing heart murmur o Abx such as amoxicillin, ampicillin, and clindamycin are given o Prophylactic therapy before dental work is necessary Rheumatic Fever: the result of an abnormal immune response to a group A strep infection, usually pharyngitis, in a genetically susceptible host. o Occurs most often in late school-age children and adolescents and is RARE in adults o Involves the joints, skin, brain, and heart, but cardiac valve damage occurs in more than half of the cases o Linked with upper respiratory tract infections o s/s: tachycardia, cardiomegaly, new/change in murmurs, muffled heart sounds, pericardial friction rub, chest pain, changes in ECG o an elevated ASO titer indicates infection o Abx are given as well as salicylates for the inflammatory process Symptoms of decreased heart function in CHF Impaired myocardial function o Tachycardia, sweating, oliguria, fatigue, restlessness, cool extremities, weak peripheral pulses, cardiomegaly Pulmonary Congestion (left side) o Tachypnea, dyspnea, retractions, orthopnea, cyanosis, wheezing Systemic Venous Congestion (right side) o Weight gain, hepatomegaly, edema, ascites, neck vein distension CHF may be unilateral or bilateral Polycythemia and clubbing- what are they and what do they indicate Polycythemia: refers to an increase in the number of red blood cells in the body. The extra cells cause the blood to be thicker, and this, in turn, increases the risk of other health issues, such as blood clots. o This occurs as a response to the body’s increased need for oxygen Clubbing: result of decreased oxygen in the blood
