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Pediatric Cardiovascular System

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With ________, the child may have mild CHF, cyanosis, a murmur, or cardiomegaly.
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Pulmonary stenosis
What are the four characteristic defects associated with Tetrology of Fallot?
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VSD-ventricular septal defect, Pulmonic stenosis, Overriding aorta-a shift to midline and Right ventricular hypertrophy-increases right side pressure
What congenital heart defect is associated with a boot shaped heart on an X-ray?
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Tetrology of Fallot
What happens in the heart during a Tet spell, and what condition is it associated with?
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Tetrology of Fallot. A spasm of the pulmonary artery results in shunting of right ventricle blood into aorta. Occurs when crying, straining, feeding. It is a significant right-to-left shift(deoxygenated blood is going out into systemic circulation). It is a life threatening hypercyanotic spell
What are the treatments for a child who is having a Tet spell?
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Knee to chest position & medications (Inderal, oxygen, morphine)—relieves spasm & improves blood flow
How is tetrology of fallot treated?
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Shunt (BT, used temporarily until big enough for complete repair
During a Tet spell, a spasm of the _____ results in shunting of _____ ventricle blood into _______. Occurs when crying, straining, feeding. It is a significant right-to-left shift(deoxygenated blood is going out into systemic circulation).
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Pulmonary artery, results in right ventricle blood shunting into the aorta
Which congenital heart defect? Mixed blood flow, Incompatible with life unless PDA or septal defect, if present, try to keep the defect open as long as possible to buy time to fix the problem, PA leaves the left ventricle, Ao leaves the right ventricle…no communication between pulmonary and systemic circulation. Oxygenated and deoxygenated blood always remains oxygenated and deoxygenated.
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Transposition of the Great Arteries (TGA)
How is Transposition of the Great Arteries (TGA) treated?
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The child will be on prostins (PGE1) to keep the foramen ovale open until surgery, septosomy until surgery,once bigger- surgical switch
What congenital heart defect? Aorta and pulmonary are fused together and are one giant artery
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Truncus arteriosus
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What are the common signs and symptoms related to truncus arteriosus?
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CHF, cyanosis, failure to thrive, activity intolerance, murmur
How is a truncus arteriosus treated?
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Resection and patching
What congenital heart defect? Atrial and ventricular septal defects Left to right shunt Occurs in many children with Downs Syndrome Poor valve formation
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AV Canal
What congenital heart defect? Valves between the right atrium and right ventricle fail to develop. No opening to allow blood to flow from the pulmonary artery to the lungs Cyanotic condition
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Tricuspid atresia
What congenital heart defect? The pulmonary veins don't connect to the left atrium, they connect to the right atrium, typically via the superior vena cava. More common in boys. Cyanotic condition.
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Total Anomalous Pulmonary Venous Connection (TAPVR)
What is the treatment for Total Anomalous Pulmonary Venous Connection (TAPVR)?
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Prostins to keep FO open and anastamosis PV to LA
What congenital heart defect? The child won’t survive the problem. Usually live about 6 weeks. Can go on transplant list or get surgery. Triad of surgeries. Only 25% chance of surviving each surgery. Left ventricle and aorta are very small.
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Hypoplastic Left Heart Syndrome (HLHS)
What symptoms are typically exhibited by infants with congenital heart defects?
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Cyanosis (generalized), Cyanosis (with exertion), Fatigue, Dyspnea, FTT, Frequent respiratory infections, Feeding difficulties, Excessive sweating, Syncopal attacks
What symptoms are exhibited by children with congenital heart defects?
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Impaired growth, Frail body, Fatigue, Dyspnea, Orthopnea, clubbing of the fingers and toes, Headache, Squatting to relieve dyspnea, Epistaxis
What are the benefits to providing preoperative education to a child about to undergo a cardiac procedure?
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Helps reduce anxiety, builds trust and improve cooperation
Children who undergo cardiac procedures often have a chest tube inserted to manage drainage. What amount of drainage is a cause for concern and warrants a call to the physician?
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Drainage of > 3ml/kg/hr for 3 consecutive hours warrants contacting MD- may indicate hemorrhage
  
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