HEART LESIONS & PHYSIOLOGY
A hole between the atria.
What is an ASD (atrial septal defect)?
This non-invasive monitor is standard in the ICU but may be less reliable in patients with poor perfusion or certain shunt lesions.
What is pulse oximetry, or SpO₂?
In a patient with pulmonary undercirculation, your vent strategy should support oxygenation by adjusting these two settings carefully.
What are FiO₂ and PEEP?
The pH minimum we keep most kids in the Heart Center.
What is 7.30?
After cardiac surgery, this common lung problem shows up as patchy or lobar collapse on x‑ray and often improves with recruitment and positioning.
What is atelectasis?
A large VSD causes a left‑to‑right shunt, which primarily increases blood flow to this area.
What is the pulmonary circulation (lungs)?
In many single-ventricle or ductal-dependent lesions, we intentionally avoid 100% saturation and instead target this approximate SpO₂ range to balance Qp:Qs.
What is 75–85%
Hyperventilating a patient generally does this to PVR, which can be harmful in some single ventricle patients.
What is it decreases PVR, increasing pulmonary blood flow and potentially stealing flow from the systemic circulation?
This is the patient population where we allow permissive hypercapnia in the Heart Center.
What is a Glenn?
These drains placed after cardiac surgery can affect lung expansion and must be considered when assessing breath sounds and chest x-rays.
What are chest tubes?
This ductal-dependent lesion requires a patent ductus arteriosus to provide systemic blood flow and often presents with shock when the ductus closes.
What is hypoplastic left heart syndrome, or HLHS?
This technology is often used during and after cardiac surgery to trend regional brain or somatic oxygenation.
What is near-infrared spectroscopy, or NIRS?
This measurement, determined by PEEP, PIP, and I-time, can decrease venous return and cardiac output if it is too high.
What is mean airway pressure?
The 5 cyanotic heart defects that start with the letter "T."
1. Truncus Arteriosus
2. TGA
3. Tricuspid Atresia
4. TOF
5. TAPVR
On a chest X‑ray, this post‑op complication appears as blunting of costophrenic angles or large opacities and can cause decreased breath sounds.
What is a pleural effusion?
In single ventricle physiology (e.g., Norwood), the same ventricle supplies both pulmonary and systemic blood flow. We call these two flows by these abbreviations.
What are Qp (pulmonary blood flow) and Qs (systemic blood flow)?
This blood level rises when tissues are not getting enough oxygen and is often trended in post-op cardiac kids to assess perfusion.
What is lactic acid?
In a fragile cardiac patient, a sudden drop in blood pressure after a PEEP increase is most likely due to this hemodynamic effect.
What is decreased venous return and reduced cardiac output?
The max HFNC flow and FiO2 for Shunt-Dependent patients on the CACU for a 3-5kg patient.
What is 6lpm and 50% FiO2
Inhaled nitric oxide (iNO) is a great tool for PPHN in the NICU but in the Heart Center, we use it to ___.
Decreased pulmonary vascular resistance.
In a Glenn circulation, systemic venous blood from the upper body drains directly into this structure without passing through the ventricle first.
What is the pulmonary artery?
One lesion where your team might intentionally accept SpO₂ in the mid‑70s to mid‑80s, and briefly say why.
Single ventricle/Norwood or Glenn patient, because lower sats help keep Qp and Qs balanced and preserve systemic perfusion.
A post‑op cardiac child is on pressure control ventilation. You see rising PaCO₂ and low tidal volumes while pressures are unchanged.
Name one likely cause and one RT action.
Likely cause: ddecreased lung compliance (atelectasis, edema) or increased resistance.
RT action: perform recruitment maneuvers, suction, adjust pressures, or notify team.
This medical director on the Heart Center can be seen educating fellows and residents during rounds in the CICU.
Who is Shanelle Clark?
A child on iNO is being weaned. List one sign that the patient is not tolerating the wean and one RT action.
Sign: rising pulmonary pressures, desaturation, increased work of breathing, or hemodynamic instability.
RT action: notify team, consider returning to previous iNO dose, ensure adequate oxygenation and ventilation.