9. HEART DEFECTS

Atrial Septal Defect

An opening exists between the heart’s two upper chambers. This lets some blood from the left atrium (Blood that’s already been to lungs) return via the hole to the right atrium instead if flowing through the left ventricle, out the aorta and to the body.

Foramen Ovale

• Hole which can be found in the right and left atrium instead if flowing the fetal circulation, that closes in adult circulation

Atrial Septal Defects

Hole between the two ATRIA

Acyanotic Defects

Left to Right Shunting

• Congenital

• Normal looking baby

  MAJOR: Decrease CARDIAC OUTPUT

  MINOR:

  1. Increased Pulmonary Blood flow

     • VSD - Ventricular Septal Defect

     • AST - Atrial Septal Defect

     • PDA - Patent Ductus Arteriosus

  2. Obstruction to the blood-flow from the ventricles

     • COA - Coarctation of the Aorta

     • AS - Aortic Stenosis (Narrowing)

     • PS- Pulmonic Stenosis (Narrowing)

Signs and symptoms : ACYANOTIC

• Tachycardia (Pulmonary compensatory mechanism)

• Hypotension ( Lower)

• Bounding Pulse (Upper)

• Machinery Like Murmur (PDA, VSD, ASD = due to hole)

• Chest pain

• Dizziness (ALOC, restlessness, irritability)

• Dyspnea

Medications/ Management

Goal: Close the PDA (Machinery-like murmur)

• Indomethacin

• Ibuprofen

Cyanotic Heart Defect

MAJOR: Mixing (Un02+02→ Blood)

A. Decreased pulmonary blood flow

• Tetralogy of Fallot → Four abnormalities that results in insufficient blood supply in the body.

P→ Pulmonic Stenosis

R→ Right Ventricular hypertrophy

O→ Overdoing of aorta

V→ Ventricular Septal Defect

Eto lang APAT

B. Mixed Blood flow

• Transportation of Great Arteries

• Truncus Arteriosus

Transition of Great Arteries

Truncus Arteriosus

Manifestations

1. Feeding difficulties

2. Tachycardia

3. Underweight

4. FFT/ Failure to Thrive

5. 3Cs (Cyanosis, Clubbing of the fingers, Crouching)

6. Blue spell/ Tet spell/ Dying spell (Hypercyanotic episodes)

Triggers of Blue spell (hyper cyanotic episodes)

1. Anything that causes increase oxygen demand

2. Crying

3. Feeding

4. Invasive procedures

Nursing Interventions

1. Position: Knee chest → Decrease workload of the heart

2. TDA: Morphine → Sedation

3. ToGA: Alprostadil (Prostaglandin E1) → Open the foramen ovale