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Flashcards in Pediatric Disease Deck (7)
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1

Atrial Septal Defect

- Persistent opening(s) across atrial septum
- Left-to-right shunt
- Acyanotic
- Includes "secundum atrial defect" (m/c) and "patent foramen ovale"
- Causes dilation of right heart chambers, overperfusion of pulmonary circulation
- Rare consequences include pulmonary vascular disease (>20y), CHF and failure to thrive (<1y)

2

Patent Ductus Arteriosus

- Persistent opening between aortic arch and pulmonary arteries
- Systemic-to-pulmonary shunt
- Acyanotic
- Age >3 months = "persistent patency"
- Untreated may cause CHF, Infectious Endocarditis, pulmonary vascular disease, aneurysm formation, thromboembolism, calcification
- Respiratory distress

3

Transposition of the Great Arteries

- Aorta comes from right ventricle, pulmonary artery from left ventricle
- Cyanotic
- Systemic venous return recirculated through RV to aorta, pulmonary venous return recirculated through LV to lungs
- Survival depends on patency of a right-to-left shunt (ventricular septal defect or patent ductus arteriosus)

4

Ventricular Septal Defect

- Persistent opening(s) across ventricular septum
- Most common form of congenital heart defect
- Left-to-right shunt
- Acyanotic
- S/Sx: Murmurs, tachypnea, diaphoresis (with feeding), failure to thrive
- May eventually become right-to-left shunt with progressive cyanosis if pulmonary arteriolar thickness never decreases

5

Bronchiolitis

- RSV infection of lower airways (m/c)
- Infants and toddlers < 2 years old (peak 3-6mos.)
- Obstructive airway pathology caused by inflammation
- Usually begins with mild URTI (fever, decreased appetite)
- Progresses to trouble exhaling, wheezy cough

6

SIDS

- Unexpected death of infant under 1 year of age
- Triple-risk theory of SIDS: Infant's underlying vulnerability + critical period in development + exogenous stressors
- Vulnerability = Genetic, inadequate response to hypoxemia or autonomic dysfunction
- Development = More likely to have apnea, sustained desaturations, poor ventilatory control
- Stressors = E.g Nicotine exposure or infection may reduce ventilation responses to hypercapnia and hypoxia by changing expression of serotonin receptors

7

Down Syndrome

- Trisomy 21
- Developmental delay, intellectual disabilty, congenital heart deffects, GI abnormalities, thyroid dysfunction, insulin-dependent diabetes mellitus, increased risk of upper respiratory and ear infections, atlantoaxial instability, leukemia