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Cardiovascular PowerPoint Flashcards

(107 cards)

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1
Q

in utero what heart side is dominant

A

right

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2
Q

in utero why does the blood bypass the lungs

A

because it gets O2 from the placenta

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3
Q

what utero structures help shunt blood away from lungs

A

patent ductus arterosis
patent foramen ovale

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4
Q

normal blood flow

A

vena cava
right atrium
right ventricles
pulmonary artery
lungs
pulmonary veins
left atria
left ventricle
aorta

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5
Q

in children how is the heart compared to the body

A

larger compared to rest of body

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6
Q

heart muscle develops until

A

5years

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7
Q

under 5 years how does the child increase CO

A

increase HR

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8
Q

stroke volume

A

the volume of blood ejected by the ventricle with each contraction

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9
Q

3 factors affecting stroke volume

A

preload
afterload
contractility

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10
Q

preload

A

the end diastolic volume that stretches the right or left ventricle of the heart to its greatest dimensions

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11
Q

afterload

A

the amount of resistance the heart must overcome to open toe aortic value and push the blood volume out into the systemic ciculation

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12
Q

some things to assess

A

skin color
cap refil
heart rate
blood pressure
JVD

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13
Q

thrills

A

murmur you can feel

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14
Q

S1

A

beginning of systole, AV valves close

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15
Q

S2

A

end od systole, closure of semilunar values

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16
Q

S3

A

normal in children
related to rapid filling of ventricle

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17
Q

S4

A

abnormal
heard late in diastole or early systole, heard in CHF and with decreased ventricular compliance

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18
Q

CCHD

A

pulse ox on pre ductal and post ducatal
pre: right hand
normal is >98% with less than 2-3% change

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19
Q

most defects occur during the first __ week of gestaion

A

8

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20
Q

congenital heart defects are categorized by their underlying path into 4 categroesi

A

increased pulmonary blood flow (acyanoitci)
decreased pulmonary flow (cyanotic)
obtructive
mixed

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21
Q

what is the first indication of congenital heart defect

A

murmur

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22
Q

a murmur indicates

A

turbulent blood flow with high pressure to get through a narrowed valve or through a shunt

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23
Q

increased pulmonary blood flow clinical manifestations

A

tachypnea, tachycardia, murmur, CHF, poor weight gain, diaphoresis, edema

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24
Q

decreased pulmonary blood flow clinical manifestations

A

cyanosis, hypoxic spells, poor weight gain, polycythemia

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25
obstruction clinical manifestations
diminished pulses, poor color, delayed capillary refill, decreased urine output, CHF with pulmonary edema
26
mixed defects clinical manifestations
cyanosis, poor weight gain, pulmonary congestion
27
increased pulmonary blood flow
PDA ASD VSD
28
PDA ASD VSD class
increased pulmonary blood flow (acynanotic)
29
increased pulmonary blood flow cause the blood to flow to the
lungs instead of the body
30
PDA - what is it
communication between left pulmonary artery and descending arota pulmonary artery is a lower pressure system so oxygenated blood flows into the pulmonary artery
31
when does the PDA close functionally
12-24 hours
32
when does the PDA close structurally
2 weeks then turns into a ligament
33
PDA accounts for what percent of all infants with congenital heart disease
5-10%
34
PDA clinical manifesations
may be asymptomatic dyspena tachypnea tachycardia full bounding pulses intercostal retractions poor growth murmur (KNOW THE TYPE)
35
PDA murmur claissifcation
machinery murmur during systole and diastole and a thrill in the pulmonary area
36
PDA have high risk for
frequent respiratory infections and pneumonia
37
PDA how will the left ventricle look
hypertrophic
38
clinical therapy of PDA how to close
cardiac Cath by obstruction device
39
medication for PDA closure
IV Ibuprofen or indomethacin - cannot be used if CHF is present
40
PDA prognosis
no long term sequelae if treated before pulmonary vascular disease
41
ASD what is it
opening in the atrial septum which permits left to right shunting of blood
42
ASD clinical manifestation s - small to mod
asymtomatic
43
ASD clinical manifestations - large
CHF, easy tiring, poor growth, mumur
44
large ASD murmur
soft systolic ejection murmur with fixed wide splitting of S2 may be heard
45
ASD what will the right ventricle look like
dilated
46
what is the most common cardiac defect
VSD
47
VSD what is it
opening in the ventricular septum results in left to right flow and then increased pulmonary flow
48
VSD small clinical manifestations
no symptoms
49
VSD mod to large
CHF, poor growth, decreased exercise tolerance, increased number of pulmonary infections
50
VSD murmur
systolic 3-4 left intercostal space
51
large vsd echo appearance
enlarged heart and pulmonary vascular margins on chest radiograph
52
post op Cath lab what to assess
vital signs, bleeding, infection, pressure dressing
53
decreased pulmonary blood flow
let of fallot
54
tet of fallot
dercreased pulmonary blood flow (cyanotic)
55
4 defects of tet of fallot
stenosis of the pulmonary outflow tract or valve right ventricular hypertrophy ventricular septal defect overriding aorta
56
let of allot how will the chest radiography show
BOOT SHAPTED HEARt
57
can metrology of fallout be dented by fetal echo
yes
58
TOF the child becomes hypoxic and cyanic as the
ductus artetosis closes
59
TOF s/s
polycytothemia hypoxic spells metabolic acidosis poor growth clubbing exercise intolerance systolic murmur won't eat well delayed cap refil right hand is different than left hand
60
what position do TOF toddlers go into
squat (knee to chest) to decreased the return of systemic venous blood to the heart = tetspells
61
how does squating help the TOF
increases peripheral vascular resistance and thus decreases magnitude of the right to left shunt across the VSD
62
what is the management for tetspells
place child in knee to chest maintain calm enviornment give O2 morphine or verssed IV fluids
63
in obstructive lesions what type of blood flow is impared
systemic
64
examples of obstructive
COA HLHS
65
COA HLHS type
obstructive
66
COA
narrowing of the descending aorta near the ductus arterioles or left subclavian artery
67
COA manifestations
many are asymptomatic lower blood pressure in legs and higher in arms, neck and head brachial and radial is bounding femoral and leg pulses are weak
68
newborn with COA and severe constriction may have
cyanosis of lower extremities, heart failure, and shock as the PDA closes
69
chest radiography of COA will be
cardiomegaly, pulmonary venous congestion, indentation of the descending aorta
70
what med is given to newborns with COA
prostaglandin E to reopen the ductus arterosis
71
what might be a complication of COA
HTN and aneurysms
72
what is HLHS
mitral and aortic valves are either absent or stenosed along with a small left ventricle and aorta
73
where doe HLHS need to be born
level 4 NICU
74
s/s of HLHS
progressive cyanosis and signs of CHF diminished pulses pale color delayed cap refill decreased UO no murmur
75
CXR HLHS
cardiomegaly and increased pulmonary vascular congestion
76
what med will you give for HLHS
PGE to keep PDA
77
tx for HLHS
transplant
78
mixed issues
TGA
79
TGA
mixed
80
TGA what is happening
pulmonary artery is the outflow tract for the left ventricle and the aorta is the outflow tract for the right ventricle - pulmonary artery and aorta are switched
81
what do we need for survival of TGA
PDA - so give PGE
82
in TGA does cyanosis improve with oxygen
no
83
CXR with TGA
egg shaped
84
tx of TGA
arterial switch
85
what is a complication of surgery
infective cardidis or endocarditis
86
what is Kawasaki syndrome
acute febrile systemic vascular inflammatory disorder that affects the small and midsize arteries including the coronary arteries
87
what is the leading cause of acquired heart. disease in children
Kawasaki
88
cause of Kawasaki
unknown but is thought to be an infectious trigger than leads to an autoimmune response
89
3 stages of kawaksai
acute subacute convalescent
90
acute Kawasaki
fever (5 days) >39 conjunctival hyperemia cervical lymph node enlargement strawberry tongue cracked lips rash on hands and face and trunk
91
subacute Kawasaki
no fever cracking skin (lips, fingers, toes) coronary artery aneurisms
92
treatment of Kawasaki
IVIG - 2g/kg start slow aspirin
93
what should we monitor for in Kawasaki
coronary artery answeusms
94
4 main cardio drugs
lasix o2 dig ACEI
95
s/s of dig tox in children
N/V will still have blurry vision but may not report
96
what is cardiomyopathy affecting
the hearts muscle
97
what is the most common cardiomyopathy
dilated
98
dilated cardiomyopathy
enlargement of all cardiac chambers systolic dysfunction
99
complication of dilated cardiomyopathy
blood clots increase risk for embolism
100
treatment of dilated cardiomyopathy
CHF - diuretics - ACEI - dig
101
hypertrophic cardiomyopathy
diastole dysfunction risk of sudden death in young athletes thickened left ventricular wall
102
tx for hypertrophic cardiomyopathy
beta blockers calcium channel blockers cardioverter
103
hypovolemic shock
clinical state of inadequate tissue and organ perfusion resulting from inadequate blood or plasma volume in the vascular space
104
s/s of hypovolemic shock
pale cold diaphoretic increase hr thready pulse no blanching
105
what antibiotic class is dangerous to kidney
mycin
106
what tells us there is perfusion
UO
107

Pediatrics (51 decks)

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