Shunting
What are the L to R shunts?
ASD, VSD, PDA
What is the most common CHD?
Ventricular septal defect (VSD)
What is "TOF"?
Tetralogy of Fallot
What defect involves switched great arteries?
Transposition of the Great Arteries (TGA)
What is often the first sign of CHD in children?
Heart murmur
Are L to R shunt cyanotic or acyanotic?
Acyanotic
What defect causes a continuous machine-like murmur?
Patent Ductus Arteriosus (PDA)
What position relieves a Tet spell?
Knees to chest
What medication must be given immediately in TGA?
Prostaglandins
What assessment finding suggests poor cardiac output postop?
Decreased urine output
What is the hallmark sign of a R to L shunt?
Cyanosis
What medication is used to close a PDA?
Indomethacin
Why does squatting help in TOF?
It increases systemic resistance by restricting blood flow from the femoral artery and pushes blood to the lungs
What defect shows high BP in arms and low BP in legs?
Coarctation of the Aorta
What are priority assessments in infants with CHD?
Feeding intolerance, weight gain, respiratory status
What are the 4 categories of CHD?
Increased pulm flow, decreased pulm flow, obstructive flow, mixed defects
What are early signs of CHF in infants with L to R shunts?
Tachycardia, tachypnea, sweating while feeding, poor weight gain
What are the 4 defects in TOF?
Pulmonary stenosis, RV hypertrophy, Overriding aorta, VSD
What happens when the PDA closes in Hypoplastic Left Heart Syndrome?
Rapid deterioration
What BP comparison is important in suspected coarctation?
Arms vs legs
Why do R to L shunts cause polycythemia?
Chronis hypoxia stimulates RBC production
Why do large VSDs cause recurrent resp infections?
Excess blood flow to lungs cause congestion
What are tet spells?
Hypercyanotic episodes caused by increased R to L shunting
Why are prostaglandins lifesaving in duct-dependent defects?
They keep the PDA open to allow blood mixing
Tachycardia, tachypnea, sweating, poor feeding, sudden weight gain