Congenital heart defects (increased pulmonary flow)

Congenital heart defect symptoms

increased pulse

increased respirations

developmental delays

Dyspnea/orthopnea

Fatigue

URI

FTT - poor weight gain, activity intolerance

Causes of congenital heart defects

genetics, maternal illness (rubella, CMV toxoplas, DM)

Symptoms of Congenital heart defects with increased pulmonary blood flow

fatigue

diaphoresis (during feedings)

murmur

risk for endocarditis

risk for CHF AND pulmonary HTN

growth restriction/ weight gain

What congenital conditions are associated with increased pulmonary blood flow

patent ductus arteriosus

atrial septal defects

ventricular septal defect

atrioventricular canal

Patent ductus arteriosis is what type of shunt and describe the defect and blood pathway.

L->R

Failure of ductus arteriosis to close (connection of aorta to pulmonary arteries)

Oxygenated blood from aorta into lungs

The patent ductus arteriosis is more common is what age group and that are symptoms

Preterm

asymptomatic OR dyspnea, tachypnea/cardia, decreased BP

If a large patent ductus arteriosis is present, what are expected findings and diagnsis

CHF

poor growth

hepatomegaly

Increased risk for for frequent respiratory infections and pneumonia

Treatment for patent ductus arteriosis

IB ibuprofen or indomethacin (NSAID) in preterm ONLY

Atrial septal defect is what type of shunt and describe the defect and blood pathway.

L->R

female>male

hole in atrial septum allowing for oxygenated blood to enter the right side (deoxygenated). A hole between the two atrias → failed closure of foramen ovale.

Small vs large atrial septal defect

soft systolic ejection murmur in pulmonic area

small: asymptomatic

large: CHF, FTT, frequent respiratory infection

risk for stroke

Atrial septal defect Tx

May close spontaniously within 4 years

septal occluders in cardiac catheterization

Aspirin 81mg (baby)

Why are salicylates (aspirin, peptobismol) not recommended in peds

Causes Rays syndrome - swelling in the liver and brain

Ventricular Septal defect is what type of shunt and describe the defect and blood pathway.

L→R

MOST COMMON →close w/in 6months

Hole in ventricular septum (between two ventricles) that allow blood flow between them

S/Sx for ventricular septal defect small vs large

small: can be asymptomatic

large: CHF, poor growth, activity intolerance, increased pulmonary infections, pulmonary HTN

murmurs for VSD

3-4th left intercostal at sternum

thrill present

VSD Tx

close spontaneously w/in 6 months and Sx after 6 months

No Sx until signs of CHF/pulmonary HTN

Tx/Sx for VSD

Patch between ventricles (transcatheter closure)

Highest risk with Sx in first 2 months of life, Respond well to Sx

Complications: arrhythmias, right bundle branch block, complete heart block

Pacemakers for some

Diuretics

Atrioventricular canal defect is what type of shunt and describe the defect and blood pathway.

L→R

Hole in center of heart. Single AV valve instead of mitral and cuspid. Upper and lower chambers are combined.

Common in Downs

S/sx for AV Canal Defect

CHF, tachypnea, tachycardia, avoidant/restrictive food intake, FTT, respiratory infections, repeated Respiratory failure

Holosystolic (continuous) murmur loudest left low sternum, palpate thrill.. LOUD

S/sx after AV Canal Sx and prognosis

ARRHYTHMIAS AND MITRAL VALVE REGURGITATION

residual septal defect

stenosis

Short survival rate (w/and w/out Downs Dx)

AV Canal Tx

between 2-4months to prevent pulmonary vascular disease

patches over septal defects, valve tissues for valve formation.

Infective endocarditis prohylaxis is required until 6 months after Sx