Reactive Airway Disease - Pediatric Pearls

What 4 history items are assessed in pediatric pulmonary edema/CHF?

Congenital heart disease; chronic lung disease; congestive heart failure; past medical history.

In an infant with pulmonary edema/CHF, who is usually well aware of the chronic condition?

The parents.

What are the 5 signs of pulmonary edema/CHF in an INFANT?

Respiratory distress; poor feeding; lethargy; weight gain; +/- cyanosis.

Weight gain and poor feeding are signs of pulmonary edema/CHF in which pediatric age group?

Infants.

What 4 RESPIRATORY signs of pulmonary edema/CHF are seen in a child or adolescent?

Respiratory distress; bilateral rales; orthopnea; pink, frothy sputum.

What 2 FLUID/VENOUS signs of pulmonary edema/CHF are seen in a child or adolescent?

Jugular vein distention (rare); peripheral edema.

What 3 GENERAL signs of pulmonary edema/CHF are seen in a child or adolescent?

Apprehension; diaphoresis; chest pain.

How common is jugular vein distention in a child or adolescent with pulmonary edema/CHF?

Rare.

What 2 circulatory findings can occur in pediatric pulmonary edema/CHF?

Hypotension; shock.

In pediatric patients, what usually determines the type of congenital heart condition?

Age.

What 3 congenital heart conditions are typical in infants LESS THAN 1 MONTH old?

Tetralogy of Fallot; transposition of the great arteries; coarctation of the aorta.

At what age do Tetralogy of Fallot, transposition of the great arteries, and coarctation of the aorta typically present?

Less than 1 month old.

Why is an infant under 1 month with a congenital heart condition usually unable to complete feedings?

Lethargy.

When may an infant under 1 month with a congenital heart condition become cyanotic?

During feeding or stress.

What 2 congenital heart conditions are typical in infants 2 TO 6 MONTHS old?

Ventricular septal defects (VSD); atrioseptal defects (ASD).

At what age do VSD and ASD typically present?

2 to 6 months old.

What 4 heart conditions can occur at ANY pediatric age?

Myocarditis; pericarditis; SVT; heart blocks.

At what pediatric age can myocarditis, pericarditis, SVT, and heart blocks occur?

Any age.