Nessa

Osuna Cardiac Notes for Pediatrics test #3

Name
Picture
Ventral Septal
Defect
(VSD)

Atrial Septal
Defect
(ASD)

Signs and Symptoms

Most common! Abnormal
connection between the R
and L ventricles. Lowers
Cardiac Output.
Flow from L to R, pulmonary
congestion.
*Asymptomatic
*CHF
*Enlarged heart
*Acyanotic

Treatment
-Surgical repair
-May close by 2 yrs
old.

Flow from L to R, pulmonary

congestion.

*Asymptomatic
*CHF
*Acyanotic

-Diuretics for CHF

-Surgery

Nursing Notes

You can wait for

surgery if
asymptomatic bc
it may resolve
spontaneously.

As the murmur
gets louder, the
hole is closing.

Nessa Osuna Cardiac Notes for Pediatrics test #3

Tricuspid
Atresia

Patient Ductus
Arteriosus

Absent tricuspid valve! The

Foremen Ovale is used
(remember the pressure
causes this). HIGH right-
sided pressure.
Unoxygenated blood is
shunted to L. atrium into the
L. ventricle then to the body
and lungs.

Increase
pulmonary blood
flow by using the
patent ductus
arteriosus with
Prostiglandin
*Surgery
-glenn procedure
-atrial septostomy
-shunting
-fontan procedure

There is currently
NO way to
replace an atrial
valve

Left to right shunting. Fibers

dont respond to the increase
in O2 after birth.
*Continuous murmur below
left clavicle
*Asymptomatic or murmur
*Bounding pulses
*Widening pulse pressure of
>20 (systolic-diastolic)

Indomethacin:
*preterm only!
*NSAID
*prostaglandin
inhibitor
*only if no other
defects &
asymptomatic

other option:
-surgery

Dx: by echo or
xray

Nessa Osuna Cardiac Notes for Pediatrics test #3

Atrio-
ventricular
Septal Defect

Aortic
Stenosis

Coarctation of
the Aorta

Severe left to right shunt.

LUNGS ARE MOST
EFFECTED
*severely impaired Cardiac
Output

See ASD & VSD

See ASD & VSD

Not always the valve. Could

be general area.
*Hypertrophy of L. Ventricle
*Enlarged heart

Meds can reduce

symptoms (<BP)
but cannot cure.

Surgery: valve
replacements and
catheterizations

This is found to
be one of the
reasons for kids
falling dead
during sports.

Pinching/stricture of the
aorta. High pressure behind
and in front.
*BP okay in hands/arms but
low in lower limbs.
*Bounding pulses in upper
body but weak in lower.

*Prostaglandin E1
to open artery by
relaxing the
muscle.
*Diuretics and
inotropic drugs to
treat s/s
*Surgical Repair
*Catheterization

Always check
pulses both sides
and upper and
lower
extremities!

Nessa Osuna Cardiac Notes for Pediatrics test #3

Transposition
of the Great
Arteries

Total
Anomalous
Pulmonary
Connection

Unoxygentated blood enters

the R. atrium and R.
Ventricle. Parallel circulation.
*Initially appears normal
*Cyanosis develops w/in a
few hours of life

Prostiglandin
immediately to
keep PDA open.

Surgery

This is NOT
compatible with
life. You WANT
another defect to
help.

Can be detected
by US if they
receive prenatal
care.

*Cyanosis develops w/in a

few hours to a few weeks of
life depending on
configuration
*Tachypnea
*Dyspnea
*Snowman-figure 8
appearance on chest xray
*R. Ventricular hypertrophy
*Enlarged heart
*Murmurs

Surgery to
Sometimes can be
reconnect the
detected in utero
pulmonary arteries via ultra sound.
to the left atrium
and to close the
(ASD) atrial septal
defects

Nessa Osuna Cardiac Notes for Pediatrics test #3

Truncus
Arteriosus

*Cyanosis develops w/in a

week or two of life
*CHF s/s
*Hazy chest x-ray
*Possible hepatomegaly
*Poor feeding
*Facial swelling or neck vein
distention

Hypoplastic
Left Heart
Syndrome

Left ventricle is tiny and

aortic stenosis is present.
*O2 sats 70-80s
*Cyanosis
*Poor feeding
*Tachypnea
*Dyspnea
*Weak/rapid pulses
*Lethargy
*Cool/clammy skin
*Dilated pupils/lackluster
stare

Medicines such as
diuretics and
inotropic meds to
manage
signs/symptoms.

Surgery: separating
the pulmonary
arteries from the
truncus, closure of
the septal defects,
create connection
from pulmonary
arteries to the right
ventricle.
*Heart transplant
*3 step surgical
process (70-80%
survive; live in the
hospital)
*Do nothing

Possibly not on
exam

Not compatible
with life

Nessa Osuna Cardiac Notes for Pediatrics test #3

Pulmonary
Stenosis

Tetralogy of
Fallot

*Central cyanosis
*CHF s/s
*Possible Right-sided
hypertrophy
*Back up pressure can open
up Foreman Ovale

Prostiglandin given
to keep PDA open

Surgery:
Percutaneous
balloon
vulvuloplasty

Combination of pulmonic
stenosis, right ventricular
hypertrophy, overriding
aorta and VSD. Mixed blood
is sent out to system.
*Cyanosis
*O2 sats 80-85s
*Tachypnea
*Irritability

Treat symptoms:
-Decrease venous
return
-Conservative O2
-Comfort and stop
crying to minimize
O2 consumption

Dont want to put

a lot of oxygen on
them.

Squat knee to
chest to get O2 by
restricting
venous return
and getting O2 to
main organs.

May be
associated with
chromosomal
abnormalities