EXAM #2: CARDIAC EMERGENCIES IN CHILDREN Flashcards Preview

Cardiovascular > EXAM #2: CARDIAC EMERGENCIES IN CHILDREN > Flashcards

Flashcards in EXAM #2: CARDIAC EMERGENCIES IN CHILDREN Deck (25)
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1
Q

What are Dr. Mooridian’s D and E in resuscitation?

A
D= draw labs or give drugs 
E= Echo
2
Q

What labs should you draw for a sick child?

A

1) Blood gas
2) CBC
3) CMP
4) Blood culture

3
Q

What drugs should you consider for a critically ill child?

A

1) Inotropes
2) Antibiotics
3) Sodium bicarbonate

4
Q

Case study #1, what is the ABG likely to show?

A

Metabolic acidosis

5
Q

What is the likely cause of acute cardiac decompenstation a few days after birth?

A

Closure of the PDA

6
Q

What is the more common cause of respiratory depression, tachycardia, and poor perfusion in a child–NOT cardiac decompensation?

A

Sepsis

7
Q

What does a “critical” left-sided obstruction imply?

A

Ductal patency is required for systemic output

8
Q

What is the immediate management plan for left-sided heart obstruction?

A

1) PGE1
2) Inotropic support
3) Correct metabolic acidosis
- IV fluid
- Sodium bicarbonate

9
Q

Should the patient with left-sided obstruction be given oxygen?

A

NO!!!

Oxygen is a pulmonary vasodilator, which will DROP pulmonary vascular resistance needed to shunt blood from right-to-left

10
Q

What is the definitive therapy for left-sided obstruction?

A

1) Balloon valvuloplasty/ angioplasty

2) Surgery

11
Q

Read case #2. What is going on?

A

Critical right-heart obstruction

12
Q

What is the immediate management for right-sided heart obstruction?

A

1) PGE1
2) Inotropic support
3) Correction of metabolic acidosis

*Oxygen may or may not be helpful

13
Q

What should you turn to if echo is normal in case #2?

A

Inhaled NO–PVR is too high and this will lower it

14
Q

What is definitive treatment for right-sided obstruction?

A

1) Balloon valvuloplasty
2) Surgical valuloplasty
3) BT shunt

15
Q

Read case #3. What is likely going on here?

A

Arrhythmia (SVT)

16
Q

What is the common etiology of SVT in children?

A
  • Underlying CHD

- S/p heart surgery from scar tissue leading to electrical abnormality

17
Q

Where does adenosine work to treat SVT?

A

Transient block of the AV node

18
Q

What are the conditions that allow for the development of a complete heart block in a child?

A

1) Child born to mother with SLE
2) Iatrogenic i.e. post-surgical
3) Inflammatory/infectious disease

19
Q

What is the treatment for complete heart block?

A
  • External pacing (short-term)

- Implantable pacemaker

20
Q

Read case #4. What is going on?

A

Cardiac tamponade

21
Q

What causes cardiac tamponade in children most often?

A

1) Post-surgical

2) Malignancy

22
Q

What is the treatment for cardiac tamponade?

A

1) Stop bleeding
2) Anti-inflammatory
3) Pericardiocentesis

23
Q

Read case #5. What is going on?

A

Pleural effusion

24
Q

What are the treatments for Chylothorax?

A

1) Pleurocentesis
2) NPO
3) IV diuretics
4) Octerotide

25
Q

Read case #6. What is going on here?

A

Clot in the BT shunt