PEDS Module 5: Circulation

What is congenital heart disease?

Structural anomalies of the heart present at birth.

What structures can be affected in congenital heart disease?

The interior wall of the heart, valves, arteries, and veins connected to the heart.

What is acquired heart disease?

Heart disorders that develop after birth.

How are congenital heart defects classified?

Based on hemodynamic characteristics:

• Increased pulmonary blood flow

• Decreased pulmonary blood flow

• Mixed disorders

What are "Pink Babies"?

Infants with congenital heart disease involving increased pulmonary blood flow (acyanotic).

What are "Blue Babies"?

Infants with congenital heart disease involving decreased pulmonary blood flow (cyanotic).

What are mixed disorders in congenital heart defects?

Conditions that involve a mixture of oxygenated and deoxygenated blood within the heart.

What are disorders with decreased pulmonary blood flow?

• etralogy of Fallot

• Tricuspid atresia

What are disorders with increased pulmonary blood flow?

• Patent ductus arteriosus (PDA)

• Atrial septal defect (ASD)

• Ventricular septal defect (VSD)

What are obstructive disorders in congenital heart defects?

• Coarctation of the aorta

• Aortic stenosis

• Pulmonary stenosis

What are mixed disorders in congenital heart defects?

• Transposition of the great vessels (TGV)

• Total anomalous pulmonary venous return (TAPVR)

• Truncus arteriosus

• Hypoplastic left heart syndrome

What are types of acquired heart disease?

• Heart failure

• Rheumatic fever

• Kawasaki disease

• Endocarditis

What are the 4 classic features of Tetralogy of Fallot?

• Ventricular Septal Defect – hole between the right and left ventricles

• Pulmonary Stenosis – narrowing of the pulmonary valve or artery

• Overriding Aorta – aorta sits over the VSD, receiving blood from both ventricles

• Right Ventricular Hypertrophy – thickening of the right ventricle

What happens when oxygen-poor blood mixes with oxygen-rich blood in Tetralogy of Fallot?

Oxygen-poor blood can flow into the aorta, leading to cyanosis because less blood reaches the lungs to get oxygenated.

What is Patent Ductus Arteriosus (PDA)?

A fetal blood vessel, the ductus arteriosus, fails to close after birth, connecting the pulmonary artery to the aorta, which normally closes within a few days after birth.

What happens in Coarctation of the Aorta?

There is narrowing of the aorta, restricting blood flow.

What happens in Transposition of the Great Vessels?

The pulmonary artery and aorta are switched, creating two separate circulations:

1. Body → heart → body

2. Lungs → heart → lungs

What are common signs of a cardiac disorder?

• Cyanosis

• Irregular heart rate

• Edema

• Clubbing of fingertips

• Fever

• Retractions or increased work of breathing

• Chest deformities

• Visible, engorged, or abnormal pulses

• Abdominal distention

• Sweating during feeding

• Feeding difficulties

• Orthopnea

• Chest pain

• Tachycardia

• Dyspnea

• Irritability

• Lethargy

What does cyanosis indicate in a cardiac disorder?

It indicates a lack of oxygen in the blood, often leading to a bluish tint to the skin

What does edema refer to in a cardiac disorder?

: Edema is the swelling caused by fluid retention, often seen in the legs, abdomen, or around the eyes.

What does clubbing of fingertips indicate in a cardiac disorder?

It is a sign of chronic hypoxia (low oxygen levels in the blood) often associated with heart or lung disease.

What are feeding difficulties and sweating during feeding signs of in heart failure?

These signs indicate the heart’s inability to pump enough blood, causing fatigue and poor feeding tolerance.

What is pulse oximetry used for in cardiovascular disorders?

Pulse oximetry is used to measure the oxygen saturation level of the blood, helping to detect hypoxemia.

What is the purpose of an Electrocardiogram (ECG) and Holter monitoring in diagnosing cardiovascular disorders?

ECG records the electrical activity of the heart, while Holter monitoring continuously records heart activity over 24-48 hours to identify arrhythmias.

What does an echocardiogram evaluate in cardiovascular disorders?

An echocardiogram uses ultrasound waves to produce images of the heart, assessing its structure, function, and blood flow.

How is a chest radiograph helpful in diagnosing cardiovascular disorders?

A chest radiograph (X-ray) can show heart size, lung condition, and signs of fluid buildup or congestion related to heart failure.

hat does an exercise stress test assess in cardiovascular health?

It evaluates the heart’s response to physical stress (exercise) and helps identify ischemic changes or arrhythmias.

What laboratory tests are commonly performed for cardiovascular disorders?

• CBC (Complete Blood Count)

• BMP (Basic Metabolic Panel)

• C-reactive protein (CRP)

• Erythrocyte sedimentation rate (ESR)

What is the purpose of an arteriogram and cardiac catheterization?

These procedures involve inserting a catheter into the heart or blood vessels to assess blockages, narrowings, or other structural issues.

How do blood gas tests help in cardiovascular diagnoses

Blood gas tests measure the oxygen and carbon dioxide levels in the blood, providing insights into respiratory and cardiovascular function.

What is the primary action of Cardiac Glycoside (Digoxin)?

Digoxin makes the heart pump more efficiently and slows the heart rate.

What are the common ACE Inhibitors used in cardiovascular disorders?

Common ACE inhibitors include Lisinopril and Captopril, which relax blood vessels and lower blood pressure.

What is the function of Beta Blockers like Atenolol?

Beta blockers reduce heart rate and blood pressure, helping to manage hypertension and prevent arrhythmias.

How do Loop Diuretics like Lasix work?

Loop diuretics help the kidneys remove excess fluid from the body, reducing swelling and lowering blood pressure.

What is Iron Replacement (Ferrous Sulfate) used for in cardiovascular care?

Ferrous sulfate is used to treat or prevent iron deficiency anemia, which can support overall heart function.

How does Digoxin (Lanoxin) help in congenital heart disease?

Digoxin improves the heart's ability to pump efficiently and slows the heart rate.

What is the role of Furosemide (Lasix) in managing congenital heart disease?

Furosemide helps the kidneys remove excess fluid from the body, improving the heart's ability to pump effectively.