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15 Cards in this Set

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What are some benign physiologic murmurs?
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
How can congenital heart disease present in the first weeks of life?
1.Cyanosis
2.CHF (tachypnea, tachycardia, +/- hepatomegaly)
3.Murmur
4.Arrhythmia
What can present as cyanosis?
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
What can cause pressure overload?
1.Aortic stenosis
2.Coarctation of aorta
What can cause volume overload with L-R shunt?
1.PDA
2.VSD
3.AV canal
4.Truncus arteriosus
What can cause myocardial dysfunction?
1.Cardiomyopathies
2.Myocarditis
3.Sustained tachyarrhythmias
4.Asphyxia
5.Sepsis
What should you look for on exam for CHD?
1.Murmur
2.Pulses
3.Perfusion
4.Hepatomegaly
5.Rales
What should your workup be for CHD?
1.Four extremities blood pressures
2.CXR
3.EKG
4.Hperoxia test
5.Echocardiogram
What do you need to do to stabilize an infant with CHD?
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)
What do patients with HLHS have?
1.Hypoplastic left ventricle
2.Left sided outflow tract
3.Hypoplastic aortic arch
What do HLHS systemic output depend on?
Ductal dependent
-with duct patent, pt may develop excessive pulmonary blood flow and loss of systemic cardiac output.
When do symptoms appear in HLHS?
-Soon after birth, usu efore 1 wk of age.
What sx do HLHS present with?
1.Murmur
2.Poor perfusion, decreased pulses
3.Hpotension
4.Respiratory distress
5.Cyanosis.
What is the workup for HLHS?
1.ABG, CBC, CMP, Bcx
2.CXR, Echo
3.NUS (30% have CNS anomalies,) Chomosome (Turner, CHARGE, VATER, Trisomy 18)
How do you manage HLHS?
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