Care of Children with Cardiac Problems Flashcards
(87 cards)
1
Q
Circulation of Blood Through the Heart
A
- inferior vena cava and superior vena cava
- right atrium
- tricuspid valve
- right ventricle
- pulmonary valve
- pulmonary artery
- lungs
- left atrium
- mitral (bicuspid) valve
- left ventricle
- aortic valve
- aorta
- rest of body
2
Q
protective covering
A
Pericardium
3
Q
parietal and visceral (epicardium) layers create a protective sac containing a small amount of lubricating fluid that reduces friction
A
Pericardium
4
Q
cardiac muscle cells
A
Myocardium
5
Q
contraction
A
systole
6
Q
relaxation
A
diastole
7
Q
rhythmic contraction (systole) and relaxation (diastole) pumps blood through systemic and pulmonary circulations
A
Myocardium
8
Q
closure during early systole produces S1
A
ATRIOVENTRICULAR VALVES
9
Q
Tricuspid valve on _______
A
right
10
Q
Mitral (bicuspid) valve on the _____
A
left
11
Q
3 Parts of valves:
A
- flaps/ cusps
- Chordae tendinae
- Papillary muscles
12
Q
closure at the end of systole produces S2
A
SEMILUNAR VALVES
13
Q
ATRIOVENTRICULAR VALVES
A
- Tricuspid valve on right
- Mitral (bicuspid) valve on the left
14
Q
SEMILUNAR VALVES
A
- Pulmonic valve
- Aortic valve
15
Q
the _____________ drain blood from the heart into the ______________.
A
coronary veins; coronary sinus
16
Q
the volume of blood ejected from the left ventricle (or the right ventricle) into the aorta (or pulmonary trunk) each minute.
A
CARDIAC OUTPUT (CO)
17
Q
CARDIAC OUTPUT (CO)
A
heart rate x stroke volume
18
Q
the volume of blood ejected by the ventricle during each contraction
A
Stroke volume
19
Q
is the source of O2 for the fetus
A
Placenta
20
Q
chamber with the highest O2 concentration
A
Right atrium
21
Q
Ductus venosus constricts within ______ days after birth and becomes ________________
A
3-7; ligamentum venosum
22
Q
closes when pressure on left atrium exceeds that of the right atrium
A
Foramen ovale
23
Q
connects pulmonary artery to the aorta
A
Ductus Arteriosus
24
Q
Causes of Congenital Heart Disorders
A
- failure of heart to progress beyond embryonic development
- maternal rubella
- heredity
25
CLASSIFICATIONS
TRADITIONAL
1. Acyanotic Heart Disease
2. Cyanotic Heart Disease
HEMODYNAMIC CHARACTERISTICS
1. Disorders w/ increased pulmonary blood flow
2. Disorders with obstruction of blood flow
3. Disorders with decreased pulmonary blood flow
4. Disorders with Mixed Blood Flow
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DISORDERS WITH INCREASED PULMONARY BLOOD FLOW
Ventricular Septal Defect
Atrial Septal Defect
Patent Ductus Arteriosus
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w/ opening in septum of 2 ventricles
Ventricular Septal Defect
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Ventricular Septal Defect results to
right ventricular hypertrophy and pulmonary hypertension
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signs and symptoms of Ventricular Septal Defect
Easy fatigability
Low, harsh, pansystolic murmur
Palpable thrill/ vibration
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Management of Ventricular Septal Defect:
- Cardiac catheterization or Transcatheter Closure (TCC)
- Open heart surgery
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abnormal communication between 2 atria
Atrial Septal Defect
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Atrial Septal Defect results to
right ventricular hypertrophy and pulmonary hypertension
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opening @ lower end of septum
Ostium primum defect (ASD 1)
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opening near center of septum
Ostium secundum defect (ASD 2)
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superior portion of atrial septum fails to form near junction of atrial wall with superior vena cava
Sinus venosus defect
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signs and symptoms of Atrial Septal Defect
- Harsh systolic murmur
- Fixed splitting
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Management of Atrial Septal Defect:
Surgery
Cardiac Catheterization or Transcatheter Closure (TCC) with
occlusive device
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blood shunt from aorta to pulmonary artery
Patent Ductus Arteriosus
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Patent Ductus Arteriosus results to
right ventricular hypertrophy, pulmonary hypertension and cardiomegaly
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signs and symptoms of Patent Ductus Arteriosus
Wide pulse pressure
Low diastolic pressure
Continuous machine like murmur
Heartbeat heard in left 2nd or 3rd intercostal space
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Management of PDA:
1. IV indomethacin
2. Ibuprofen
3. Cardiac catheterization
4. Ductal ligation
42
narrowing of pulmonary valve or pulmonary artery resulting to decreased blood flow to the lungs
Pulmonary Stenosis
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Pulmonary Stenosis results to
right ventricular hypertrophy
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signs and symptoms of Pulmonary Stenosis
Cyanosis
Systolic ejection murmur
Thrill
Widely split 2nd heart sound (“lub b’ dub”)
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management of Pulmonary Stenosis
Balloon Angioplasty or Valvotomy
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stricture of aortic valve
Aortic stenosis
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Aortic stenosis results to
increase pressure and hypertrophy of left ventricle & pulmonary edema
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signs and symptoms of Aortic stenosis
Rough systolic murmur
Thrill
Chest pain
If severe- faint pulses, hypotension, tachycardia, inability to suck
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Management of Aortic stenosis
1. Beta blocker or Ca channel blocker- for stabilization
2. Balloon valvuloplasty
3. Artificial valve replacement
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narrowing of the aorta near insertion of ductus arteriosus
Coarctation of the Aorta
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signs and symptoms of Coarctation of the Aorta
1. increased systemic circulation above stricture
2. decreased systemic circulation below stricture
3. left ventricular hypertrophy
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Management of Coarctation of the Aorta:
1. Angioplasty
2. Surgery
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TETRALOGY OF FALLOT
1. Pulmonary Valve Stenosis
2. VSD
3. Overriding of the aorta: receiving blood from both ventricles or aorta arising from right ventricle
4. Hypertrophy of right ventricle
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TETRALOGY OF FALLOT signs and symptoms
Polycythemia
Clubbing of fingers
Severe Dyspnea
Squatting position when resting
Growth restriction
Tet spells
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TETRALOGY OF FALLOT Management:
1. Blalock-Taussig Procedure
2. Keep hypoxic episode to minimum
3. Brock procedure
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palliative treatment; surgery to increase pulmonary blood flow which can be done prenatally;
Blalock-Taussig Procedure
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repair of all anomalies (performed soon after birth)
Brock procedure
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aorta arises from right ventricle instead of the left, pulmonary artery arises from the left instead of the right
Transposition of great arteries
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An inflammatory disease that occurs after an infection with GABHS pharyngitis
RHEUMATIC FEVER
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one of the small nodules in heart muscle that are typical of rheumatic heart disease and consist of swollen collagen, cells, and fibrils
Aschoff Bodies
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Major Criteria for Rheumatic Fever
Joint Involvement
Myocarditis
Nodules, subcutaneos
Erythema marginatum
Sydenham Chorea
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Minor Criteria for Rheumatic Fever
CRP Increased
Arthralgia
Fever
Elevated ESR
Prolonged PR Interval
Anamnesis of Rheumatism
Leukocytosis
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Drug level must be maintained for _______ days
10-14
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Management of Rheumatic Fever
1. Penicillin or erythromycin
2. Benzathine penicillin IM
3. Corticosteroids
4. Phenobarbital & diazepam
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Mucocutaneous lymph node syndrome; febrile, multisystem disorder
Kawasaki Disease
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is the principal & life threatening findin of Kawasaki Disease because it can lead to MI or aneurysm
Vasculitis
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Therapeutic Interventions for Kawasaki Disease
1. Aspirin or Ibuprofen
2. abciximab
3. IV Ig
4. Avoid steroids
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Reduction in the concentration of RBCs or hemoglobin
ANEMIAS
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Classification of Anemia:
1. Iron Deficiency Anemia:
2. Megaloblastic Anemia
3. Aplastic Anemia
4. Hemolytic Anemia
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Commonly caused by GI bleeding, menstruation, malignancy; other causes include inadequate dietary intake, malabsorption, and increase demand
Iron Deficiency Anemia
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associated with alcoholism, malabsorption, pregnancy, lactation
folate deficiency
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ack of intrinsic factor in stomach which prevents absorption of vitamin B12 which reduces the formation of adequate number of erythrocytes
pernicious anemia
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hypoplastic anemia; caused by bone marrow depression or destruction leading to leukopenia, thrombocytopenia, decreased erythrocytes and decreased leukocytes (agranulocytosis)
Aplastic Anemia
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excessive or premature destruction of RBCs; causes include sicke cell disease, thalassemia, glucose-6-phosphate dehydrogenase deficiency, antibody reactions, infection and toxins
Hemolytic Anemia
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stimulate bone marrow function
Epoetin
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Presence of abnormally shaped RBCs * Autosomal recessive inherited disorder
SICKLE CELL ANEMIA
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a test that measures different types of a protein called hemoglobin in your red blood cells
hemoglobin electrophoresi
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large quantity of blood pools in the spleen causing drop in BP and shock; acute episode between 8 months-5 years of age; can result in death
Sequestration crisis
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diminished RBC production due to infection; profound anemia results in rapid destruction of RBCs combined with decreased production
Aplastic crisis
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increased rate of destruction of RBC; rare complication associated with G-6-PD deficiency
Hyperhemolytic crisis
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Autosomal recessive disorder most common in individuals of Mediterranean descent
THALASSEMIA
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excessive iron storage with resultant cellular damage
Hemochromatosis
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Management of Thalassemia
1. digitalis, diuretics,low sodium diet
2. Transfusion of packed RBC
3. deferoxamine- remove excess FE
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◍ Factor VIII deficiency
◍ Sex linked recessive trait
HEMOPHILIA A
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◍ Inherited autosomal dominant
◍ Angiohemophilia
◍ With factor VII defect, platelets unable to aggregate
◍ Epistaxis is a major problem with heavy menstrual flow
VON WILLEBRAND’S DISEASE
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Also known Hemophilia B or factor IX
deficiency
CHRISTMAS DISEASE
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Factor XI deficiency or thromboplastin antecedent deficiency
HEMOPHILIA C
