Week 1 Cardiac Alterations Treatment

Acute Pericarditis

Rest; salicylates; NSAIDs; combined NSAIDs and colchicine.

Constrictive Pericarditis

Dietary sodium restriction; diuretics to improve cardiac output; anti-inflammatory drugs; surgical excision of the pericardium if medical treatment is unsuccessful.

Pericardial Effusion / Cardiac Tamponade

Pericardiocentesis to remove fluid from the pericardial space.

Dilated Cardiomyopathy

Reduce blood volume; increase myocardial contractility; treat or reverse the underlying cause.

Hypertrophic Obstructive Cardiomyopathy

Beta blockers or calcium channel blockers; surgical resection of hypertrophied myocardium; septal ablation; prophylactic implantable cardioverter-defibrillator (ICD) for high-risk patients.

Hypertensive or Valvular Hypertrophic Cardiomyopathy

Treatment focuses on managing the underlying condition and reducing increased cardiac workload.

Restrictive Cardiomyopathy

Correct or treat the underlying cause.

Valvular Heart Disease

Careful fluid management; valve repair or valve replacement with a prosthetic valve; long-term anticoagulation following prosthetic valve replacement; antibiotic prophylaxis before invasive procedures as indicated in the lecture.

Aortic Stenosis

Valve repair or valve replacement with a prosthetic valve; transcatheter aortic valve implantation (TAVI).

Mitral Stenosis

Surgical repair; valve replacement may be required.

Aortic Regurgitation

Vasodilators and inotropic agents may delay valve replacement; valve replacement may eventually be required.

Mitral Regurgitation

Surgical valve repair or valve replacement.

Tricuspid Regurgitation

Treatment directed toward management of the valve dysfunction and resulting right-sided volume overload; no specific treatment was listed on the condition slide.

Mitral Valve Prolapse Syndrome

Usually no treatment is required; beta blockers may be used when treatment is needed.

Patent Ductus Arteriosus (PDA)

Surgical closure by ligation through incision, catheter-based closure, or video-assisted thoracoscopy.

Atrial Septal Defect (ASD)

Surgical closure; closure before school age is associated with better health outcomes.

Ventricular Septal Defect (VSD)

Treatment ranges from minimal intervention/observation to surgical repair depending on severity.

Atrioventricular Canal Defect

Complete surgical repair, generally between 3 and 6 months of age.

Coarctation of the Aorta

Prostaglandin administration; mechanical ventilation; inotropic support; maintain cardiac output; surgical repair.

Congenital Aortic Stenosis

Commissurotomy; aortic valvotomy; Ross procedure.

Pulmonic Stenosis

Mild cases: close observation without treatment. Severe cases: balloon angioplasty or pulmonary valvotomy.

Tetralogy of Fallot

Surgical correction during infancy, usually before 1 year of age; Blalock-Taussig shunt; transcatheter pulmonary valve replacement; patch repair.

Tricuspid Atresia

Prostaglandin administration; Blalock-Taussig shunt; Rashkind balloon atrial septostomy; pulmonary artery banding; closure of septal defects.

Transposition of the Great Arteries

Surgical correction to switch the great arteries.

Total Anomalous Pulmonary Venous Connection (TAPVC)

Obstructed lesions are surgically repaired at diagnosis; unobstructed lesions are generally repaired during infancy; surgery connects the common pulmonary vein to the left atrium and closes the atrial septal defect.

Truncus Arteriosus

Modified Rastelli procedure; VSD patch closure to direct left ventricular blood flow into the truncus; correction/reconstruction of the pulmonary arteries.

Hypoplastic Left Heart Syndrome

Prostaglandin administration; correction of acidosis; inotropic support to maintain cardiac output; ventilatory management; staged surgical treatment; cardiac transplantation may be required.