Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
30 Cards in this Set
- Front
- Back
|
Statistics of Congenital Heart Disease
|
Approx 1% of all live births (very conservative)
Majority follow non-mendelian genetics (not always predictable) |
|
|
Causes of Congenital Heart Dis
|
Multifactorial genetics (genetic & environ)
Chromosomal abnormalities - 10% (Downs - septal defects/AV canal, Turner Syn.-coarctation) Maternal conditions -2-4% (DM, SLE, Fetal Alcohol Syn & drug addictions) |
|
|
Which are Acyanotic Congenital Heart Diseases
|
Ventricular Septal Defect (1 in 3)
Patent Ductus Arteriosus- 8% (50% will close on their own) Atrial Septal Defect -7% Coarctation -6% Aortic Stenosis -5% |
|
|
Which is Cyanotic Congenital Heart Dis?
|
Tetralogy Fallot -5% (very dangerous - blue baby)
|
|
|
What's involved in a Cardiac Assessment?
|
Heart rate
Respiratory rate - most important vital sign BP - also very important vital sign Thrills Pericardial friction rub Heart sounds Murmurs |
|
|
What are types of Skin Assessments?
|
Central cyanosis (arterial)
Peripheral cyanosis (venous Acrocyanosis Mottling |
|
|
What is Acrocyanosis?
|
Peripheral cyanosis - venous desaturation - blue around mouth & tips of extremities
|
|
|
What is mottling?
|
Lacy, fish-net appearance of skin - can be due to cold stress or sepsis
|
|
|
What are signs of Peripheral Cyanosis?
|
Blue hands/feet/perioral
Can be normal for weeks Normal reduced Hb levels Normal O2 saturations Venous desaturation - not a worry |
|
|
What are signs of Central Cyanosis?
|
Blue inner lips & tongue
Abnormal after first few hours Increased levels of reduced Hb Decreased O2 sats Arterial desaturation - great concern |
|
|
What is the normal color of mucous membranes?
|
Strawberry sherbert color
|
|
|
What is the color of cyanotic membranes?
|
Resembles rasberry sherbert (deeper color of pink)
|
|
|
What can it mean if an infant is pale or washed out?
|
May be hypoxic or anemic
Mild degrees of cyanosis can be easily missed! |
|
|
What percentage of pediatric pts will have a heart murmur?
|
50 - 90% at one time or another
Majority are functional or innocent murmurs |
|
|
S1 Heart Sound
|
Ausc with diaphragm
Located at LLSB Due to M/T closure |
|
|
S2 Heart Sound
|
Ausc with diaphragm
Located LUSB Due to A/P closure |
|
|
S3 Heart Sound
|
Ausc with bell
Located at LSB Vibration - normal Tensing - pathological -stiff heart |
|
|
S4 Heart Sound
|
Ausc with bell
Located at LSB Vibration - normal Tensing - pathological - stiff heart |
|
|
Normal S1 & S2 Sounds
|
High frequency sounds
Consists of 2 sounds: 1)Aortic and pulmonic components Determined by amount of splitting during inspiration and expiration Physiological split - normal Fixed split - bad - when it remains thru expiration & inspiration |
|
|
Grade I Systolic Murmur
|
Very faint
Requires concentration to hear |
|
|
Grade II Systolic Murmur
|
Quiet
Can be heard without difficulty |
|
|
Grade III Systolic Murmur
|
Loud
Heard immediately when placing the stethoscope on the chest |
|
|
Grade IV Systolic Murmur
|
Loud
Can be associated with a thrill - can be felt |
|
|
Grade V Systolic Murmur
|
Heard with the stethoscope partially off the chest wall
Thrill present |
|
|
Grade VI Systolic Murmur
|
Heard with stethoscope off the chest
Thrill present |
|
|
How are Diastolic murmurs graded?
|
1-4/4
Always pathological until proven otherwise (in kids) |
|
|
What are innocent murmurs?
|
functional
nonorganic benign insignificant No structural or hemodynamic problem Due to turbulence of blood flow |
|
|
Characteristics of Innocent Murmurs
|
Normal history and physical
Soft intensity (GII, occasionally GIII) Intensity varies with position Short Duration (not holosystolic) Musical quality - not harsh Normal S1 & S2 (not a fixed split) If evidence of cardiac disease is present - murmur should not be labeled "innocent" |
|
|
What is a Functional Murmur?
|
aka nonorganic or innocent
Diagnosis by exclusion in the neonate |
|
|
What is a Functional Murmur with Venous Hum?
|
Continuous humming murmur
Usually ages 2-5 Heart best under (R) clavicle Movement of head or supine position changes murmur intensity Differentiate from PDA (no change in PDA with head movement) |
