PEDS congenital heart problems

increased pulmonary blood flow

blood shunts from the high-pressure left side to the low-pressure right side, causing extra blood to flow to the lungs. The primary risk and manifestation is Heart Failure.

Right side of heart

atrial septal defect

An abnormal opening between the atria. Blood flows from the Left Atrium to the Right Atrium. This increases flow and pressure on the right side of the heart.

May be asymptomatic or develop Heart Failure (HF). A characteristic murmur is present. Repair can be done via cardiac catheterization or surgery

ventricular septal defect

An abnormal opening between the ventricles. Blood flows from the Left Ventricle to the Right Ventricle. This is the most common of the shunting defects.

A characteristic murmur is present.

20–60% of VSDs close spontaneously during the first year of life.

patent ductus arterius

The fetal ductus arteriosus fails to close. Blood flows from the high-pressure aorta to the low-pressure pulmonary artery. This increases the workload on the left side of the heart.

Can be asymptomatic or develop Heart Failure

decreased pulmonary blood flow

blood shunts from the right side to the left side, bypassing the lungs and sending desaturated (unoxygenated) blood into the systemic circulation. The primary consequence is Hypoxemia/Cyanosis

Left side of lungs

tetralogy of fallot

A combination of 4 defects (VSD, Pulmonary Stenosis, Overriding Aorta, Right Ventricular Hypertrophy). Increased pressure on the right side forces desaturated blood to shunt into the left side.

Patients are hypoxemic and appear cyanotic. This chronic state leads to signs over time:

Polycythemia (increased risk for stroke) and clubbing of the digits.

polycythyemia

An abnormal increase in the number of red blood cells (RBCs) in the blood.

clubbing of digits

A physical sign characterized by the enlargement of the fingertips (or toes) and a downward sloping (convex) of the nail beds.

hypercyanotic spells

Acute, life-threatening episodes of profound cyanosis and hypoxia, often triggered by crying, feeding, or stress. Manifestations include worsening cyanosis,

Hyperpnea (deep, rapid breathing), and limpness/fainting.

Nursing Interventions (Treating the Spell): 1. Calm and comfort the child. 2. Place the child in the Knee-Chest position. 3. Administer

O2 100%. 4. Administer Morphine sulfate. 5. Give IV fluids to increase blood volume.

obstructive defect

In this type of defect, there is a resistance to blood flow out of the heart.

coarctation of the aorta

A narrowing of the aorta (obstruction).

BP and Pulses are UNEVEN between the upper and lower body.

Proximal (Upper Body) Signs: Increased BP and Bounding pulses in the upper extremities.

Distal (Lower Body) Signs: Weak or absent femoral pulses and cool lower extremities.

transportation of the great vessels

The aorta and pulmonary artery are switched, resulting in two separate, parallel circulatory systems with little to no communication. The primary issue is the mixing of saturated and unsaturated blood.

Newborns are severely cyanotic and have depressed function at birth.

rheumatic fever

A systemic inflammatory disease that occurs after an infection with Group A Beta Hemolytic Streptococcus.

The most significant long-term complication is

Cardiac Valve Damage. Other signs:

Polyarthritis (inflammation of 2+ large joints) and Sydenham chorea (aimless, grimacing movements).

carditis

onset of new murmurs, chest pain

polyarthritis

inflammation of 2 or more large joints

erythema marignatum

non puritic skin rash with pink macules and blanching in the middle of the lesions on the trunk

sydenham chorea

aimless movements, facial grimacing due to CNS involvement

kawasaki disease

A self-limiting acute systemic inflammatory disease (vasculitis) of the medium-sized blood vessels. The cause is unknown.

MAJOR CONCERN: Vascular changes in the coronary arteries leading to Aneurysm formation.

Signs for Diagnosis: A high fever (>102.2°F) lasting over three days ,

Redness in both eyes, and a very red, swollen tongue ("Strawberry tongue").

prostagladin e

a life-sustaining medication used primarily in newborns with specific congenital heart defects. It is administered as a continuous intravenous infusion to keep the PDA open until corrective surgery can be performed

indomethacin

an intravenous medication to close a patent ductus arteriosus (PDA) in premature infants. PDA is a congenital heart defect where a blood vessel fails to close normally after birth.