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15 Cards in this Set
- Front
- Back
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What are some benign physiologic murmurs?
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1.PDA - transient left to right flow heard through the ductus arteriosus when the pulmonary venous resistance decreases.
2.PPS - Peripheral Pulmonic Stenosis -Acute angle of the pulmonary artery cuases turbulent blood flow -disappears by 6-8 mo of age 3.Still Murmur -vibratory systolic murmur thought to arise from the chordae tendineae cordis -persist up to 1-2 yr of life |
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How can congenital heart disease present in the first weeks of life?
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1.Cyanosis
2.CHF (tachypnea, tachycardia, +/- hepatomegaly) 3.Murmur 4.Arrhythmia |
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What can present as cyanosis?
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1.Right to Left Shunt
(decreased pulmonary blood flow) -Tricuspid atresia -TAPVR -TOF -Truncus arteriosus -Pulmonary atresia/stenosis 2.Intracardiac mixing, nl or increased pulmonary blood flow -Hypoplastic left heart -Complete AV canal |
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What can cause pressure overload?
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1.Aortic stenosis
2.Coarctation of aorta |
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What can cause volume overload with L-R shunt?
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1.PDA
2.VSD 3.AV canal 4.Truncus arteriosus |
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What can cause myocardial dysfunction?
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1.Cardiomyopathies
2.Myocarditis 3.Sustained tachyarrhythmias 4.Asphyxia 5.Sepsis |
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What should you look for on exam for CHD?
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1.Murmur
2.Pulses 3.Perfusion 4.Hepatomegaly 5.Rales |
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What should your workup be for CHD?
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1.Four extremities blood pressures
2.CXR 3.EKG 4.Hperoxia test 5.Echocardiogram |
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What do you need to do to stabilize an infant with CHD?
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1.ABC, lines
2.Volume resussictation,inotropic support and correctin of metabolic acidosis 3.PGE1 for ductal-dependent lesions that require PDA to be open -watch for apnea and hypotension 4.Inotropic agents (dopamine) |
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What do patients with HLHS have?
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1.Hypoplastic left ventricle
2.Left sided outflow tract 3.Hypoplastic aortic arch |
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What do HLHS systemic output depend on?
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Ductal dependent
-with duct patent, pt may develop excessive pulmonary blood flow and loss of systemic cardiac output. |
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When do symptoms appear in HLHS?
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-Soon after birth, usu efore 1 wk of age.
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What sx do HLHS present with?
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1.Murmur
2.Poor perfusion, decreased pulses 3.Hpotension 4.Respiratory distress 5.Cyanosis. |
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What is the workup for HLHS?
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1.ABG, CBC, CMP, Bcx
2.CXR, Echo 3.NUS (30% have CNS anomalies,) Chomosome (Turner, CHARGE, VATER, Trisomy 18) |
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How do you manage HLHS?
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1.PGE1 (keep duct open)
2.Volume expanders - correct hypovolemia 3.Correct metab acidosis (NaHCO3, THAM) 4.spO2 in 6070s, PaO2>30 5.BP 40-50 (pressor) 6.NPO, NG |
