Pediatric Cardiology: Heart Function, Defects, and Treatments

What is systole?

The phase when the heart contracts and ejects blood.

What is diastole?

The phase when the heart relaxes and fills with blood.

What does End Systolic Volume (ESV) refer to?

The volume of blood left in the heart after contraction.

What does End Diastolic Volume (EDV) refer to?

The volume of blood in the heart after filling.

How is Cardiac Output (CO) calculated?

CO = Heart Rate (bpm) x Stroke Volume (mL).

What is the normal CO for infants?

77 mL/Kg/min.

What can very high or very low heart rates compromise?

Cardiac output.

What is preload?

The amount of blood filling the ventricles during diastole.

What is afterload?

The load that the heart must eject against.

What is contractility?

The force of contraction of the heart.

What are common causes of congenital heart defects?

Multifactorial causes including teratogenic factors, chance, familial links, and chromosomal deletions.

What is Down's Syndrome?

A genetic condition caused by an extra chromosome (Trisomy 21) leading to congenital heart defects.

What is Turner syndrome?

A chromosomal abnormality where one of the X chromosomes is absent or abnormal, leading to aortic and valvular abnormalities.

What is cyanosis?

A bluish discoloration of the skin and mucous membranes due to hypoxemia.

What is congestive heart failure (CHF)?

The inability of the heart to pump out blood that enters it, leading to congestion in organs.

What is failure to thrive?

Decelerated or arrested physical growth associated with inadequate nutrition.

What does the Capillary refill test (CRT) assess?

Blood flow through peripheral tissues.

What is the role of an echocardiogram?

To generate images of the heart and assess its structure and function.

What is cardiac catheterization?

A procedure that involves inserting a catheter into the heart to measure pressures and assess blood flow.

What is a patent ductus arteriosus?

A condition where there is a wide muscular connection between the pulmonary artery and aorta, causing left to right shunting.

What are the management strategies for patent ductus arteriosus?

Oxygen, fluid restriction, diuretics, and possibly surgical ligation.

What triggers the closure of the ductus arteriosus at birth?

Increased oxygen concentration, acetylcholine, and bradykinin in the blood.

What is the ligamentum arteriosum?

The fibrous remnant of the ductus arteriosus after it closes.

What is the significance of increased blood flow to the lungs at birth?

It equalizes pressure in the two atria, leading to the closure of the foramen ovale.

What is the definition of central cyanosis?

Generalized bluish discoloration of the body and visible mucous membranes due to inadequate oxygenation.

What is peripheral cyanosis?

Bluish discoloration of the distal extremities due to hypoxemia.

What are the signs of congestive heart failure?

Pulmonary congestion, edema, and back pressure to organs.

What is the definition of clubbing?

Enlargement of the tips of the fingers with extremely curved nails, often associated with congenital cardiovascular defects.

What is an Atrial Septal Defect (ASD)?

A defect characterized by incomplete closure between the right and left atrium, leading to a left to right shunt.

What percentage of congenital heart defects does ASD account for?

5-12% of congenital heart defects.

Which gender is more commonly affected by ASD?

Females are affected twice as often as males.

What happens to right heart pressures after birth?

A fall in pulmonary vascular resistance (PVR) decreases right heart pressures.

What are the three types of ASD based on defect location?

Low, middle, and high septum.

What are potential complications of ASD?

Volume overload leading to right atrium and ventricle dilation, congestive heart failure (CHF), and atrial arrhythmias.

What is the management for symptomatic ASD?

Treatment may include diuretics and digoxin, with surgical intervention for low and high septum defects.

What is a Ventricular Septal Defect (VSD)?

An opening in the ventricular septum, accounting for 1/3 of all congenital heart defects.

What is the most common congenital heart defect?

Ventricular Septal Defect (VSD).

What percentage of VSDs will close spontaneously?

75% of VSDs will close spontaneously.

What is Tetralogy of Fallot (TOF)?

A congenital heart defect with four components: ventricular septal defect, pulmonary stenosis, overriding aorta, and right ventricular hypertrophy.

What are 'Tet spells'?

Paroxysmal hyperpnea episodes in children with TOF, characterized by cyanosis and rapid breathing.

What is the primary treatment for Tet spells?

Increasing systemic vascular resistance (SVR) to decrease right to left shunt.

What position do children often assume during Tet spells and why?

Children often squat to increase venous return to the right heart and reduce hypercyanotic spells.

What is Tricuspid Atresia (TA)?

A condition where the tricuspid valve is absent or imperforate, requiring blood flow through a patent foramen ovale or PDA.

What are the symptoms of Tricuspid Atresia?

Cyanosis, acute respiratory failure, hypoxemia, and acidosis.

What is the Fontan procedure?

An operation that diverts systemic venous blood to the lungs without passing through a ventricle, used for conditions like tricuspid atresia.

What are common nursing care practices for pediatric congenital heart defect patients?

Complete physical assessments, monitor vital signs, assess for signs of decreased perfusion, and manage fluid status.

What are potential complications of cardiac catheterization?

Arrhythmias, bleeding, cardiac perforation, stroke, contrast agent reactions, and infection.

What is the purpose of Prostaglandin E1 in congenital heart defect management?

To maintain ductal patency and improve blood flow.

What is the significance of monitoring for bleeding post-catheterization?

To prevent complications such as hematoma or hemorrhage at the catheter insertion site.

What is the role of indomethacin in managing congenital heart defects?

It is used to close a patent ductus arteriosus (PDA) in premature infants.

What is the primary goal of nursing care for patients with decreased pulmonary blood flow defects?

To ensure adequate oxygenation and perfusion while managing symptoms.

What is a common palliative procedure for Tricuspid Atresia?

Balloon septostomy to maximize blood flow between the atria.

What are signs of decreased perfusion in pediatric patients?

Pale skin, mottling, weak pulses, and delayed capillary refill.

What is the purpose of a BT shunt?

To increase pulmonary blood flow in patients with congenital heart defects.

What is the importance of family support in pediatric cardiac care?

To alleviate anxiety and provide education about the child's condition and care.