Defects with Increased Pulmonary Blood Flow
This defect can be described as...
Abnormal opening between the atria that is often asymptomatic that can close spontaneously in younger patients and with small defects but may need surgical intervention if moderate to large defect
Atrial septal defect
True or false
Tetralogy of Fallot repair is usually performed in the first year of life with indications for surgery being increased cyanosis and development of hyper cyanotic spells.
True
This defect can be described as
The pulmonary artery leaves the left ventricle and the aorta exits from the right ventricle with no communication between the systemic and pulmonary circulations
Transposition of the Great Arteries
high blood pressure and bounding pulses in the arms but weak or absent femoral pulses and lower blood pressure in lower extremities is hallmark for this defect
Coarctation of the Aorta
This is a result of an abnormal immune response to group A strep, usually associated with pharyngitis, that is a self-limiting disease that often involves the joints, skin, brain, and heart.
Acute Rheumatic fever
This defect can be described as....
An abnormal opening between the ventricles can manifest with heart failure-like symptoms that may need to be managed with either a pulmonary artery banding or a complete repair
Ventricular Septal Defect
With this defect acute episodes of cyanosis and hypoxia can be seen?
DOUBLE JEOPARDY
What are these called?
Tetralogy of Fallot
"blue spells or tet spells"
This defect requires surgical management that is a staged series of 3 surgeries...
Hypoplastic left heart syndrome
Norwood, Glenn, Fontan
The narrowing of the entrance to the pulmonary artery that may be asymptomatic but progressive narrowing would cause an increase in symptoms such as cyanosis or heart failure symptoms
Pulmonic Stenosis
Bacterial Endocarditis
This defect is a result of failure of the fetal ductus arteriosus to close within the first weeks of life
In this defect there is a left-to-right shunt
Patent Ductus Arteriosus
List 2 ways to treat a tet spell aka hypercyanotic spell
-Knee to chest
-calm the infant
-administer oxygen
-give morphine
-IV fluid replacement/volume expansion if needed
Page 754
True or False
With Hypoplastic Left Heart Syndrome they are expected to have normal oxygen saturations (>90%) when born.
False
Remember that this is a mixing defect and they are not expected to saturate normally as this may actually harm them as this will oversaturate them.
Narrowing or stricture of the aortic valve causes decreased cardiac output, left ventricular hypertrophy, and pulmonary vascular congestion and requires an aortic valvotomy but may require more surgeries to repair or replace the aortic valve in the future
Aortic Stenosis
A 3 year old patient has been admitted with Kawasaki disease and is now preparing for discharge. His mother states that she is glad he is getting to take ibuprofen for the next 6 weeks
This statement is
True or false
False
That patient would be expected to be sent home on low-dose aspirin not ibuprofen
pg 773
This defect can vary in size from a small pinhole to absence of a septum and is often associated with other defects
Ventricular Septal Defect
Unoxygenated blood enters through the superior and inferior vena cava and travels to the left atrium can be seen happening in this defect
Tetralogy of Fallot
What type of surgical repair is typically seen with Transposition of the Great Arteries?
An arterial switch
Coarctation of the aorta requires what kind of surgical intervention in older infants and children?
Balloon angioplasty
True or false
Oxygen is a vasodilator that decreases pulmonary vascular resistance
True
Remember that oxygen is considered a "drug" and needs to be administered with an order as there are some cases were the administration of oxygen would be detrimental to the patient.
A defect that has a characteristic washing machine like murmur
DOUBLE JEOPARDY
Administration of what medication is used to close a patent ductus?
Patent Ductus Arterious
Indomethacin (Prostaglandin inhibitor)
The classic form of Tetralogy of Fallot includes these 4 defects...
1. VSD
2. Pulmonic Stenosis
3. overriding aorta
4. right ventricular hypertrophy
With the Transposition of the great arteries to provide intracardiac mixing the patient may need to maintain ductal patency, what class of medication can be used for these patients requiring ductal patency to ensure adequate systemic blood flow?
IV prostaglandins
True or false
If you are teaching a parent of a newly diagnosed coarctation of the aorta infant what it is, a good way to explain it would be "narrowing of the aortic arch"
True
Page 722 Box 23.12'
-Changes in the extremities like peeling of the hands and feet
-bilat conjunctival infection without exudation
-cracking of the lips, strawberry tongue, changes in the oral mucous membranes
-rash: maculopapular
-cervical lymphadenopathy