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Name

Picture

Signs and Symptoms

Treatment

Ventral
Septal
Defect
(VSD)

Most common!
Abnormal connection
between the R and L
ventricles. Lowers
Cardiac Output.
Flow from L to R,
pulmonary congestion.
*Asymptomatic
*CHF
*Enlarged heart
*Acyanotic

-Surgical repair
-May close by 2
yrs old.

Atrial Septal
Defect
(ASD)

Flow from L to R,
pulmonary congestion.

-Diuretics for
CHF
-Surgery

*Asymptomatic
*CHF
*Acyanotic

Nursing
Notes

You can wait


for surgery if
asymptomatic
bc it may
resolve
spontaneously.
As the murmur
gets louder,
the hole is
closing.

Tricuspid
Atresia

Absent tricuspid valve!


The Foremen Ovale is
used (remember the
pressure causes this).
HIGH right-sided
pressure. Unoxygenated
blood is shunted to L.
atrium into the L.
ventricle then to the
body and lungs.

Increase
pulmonary
blood flow by
using the patent
ductus
arteriosus with
Prostiglandin
*Surgery
-glenn
procedure
-atrial
septostomy
-shunting
-fontan
procedure

There is
currently NO
way to replace
an atrial valve

Patient
Ductus
Arteriosus

Left to right shunting.


Fibers dont respond to
the increase in O2 after
birth.
*Continuous murmur
below left clavicle
*Asymptomatic or
murmur
*Bounding pulses
*Widening pulse
pressure of >20
(systolic-diastolic)

Indomethacin:
*preterm only!
*NSAID
*prostaglandin
inhibitor
*only if no other
defects &
asymptomatic

Dx: by echo or
xray

other option:
-surgery

Atrioventricular
Septal
Defect

Severe left to right


shunt. LUNGS ARE MOST
EFFECTED
*severely impaired
Cardiac Output

See ASD & VSD

See ASD &


VSD

Aortic
Stenosis

Not always the valve.


Could be general area.
*Hypertrophy of L.
Ventricle
*Enlarged heart

Meds can
reduce
symptoms (<BP)
but cannot cure.

This is found to
be one of the
reasons for
kids falling
dead during
sports.

Coarctation
of the Aorta

Pinching/stricture of the
aorta. High pressure
behind and in front.
*BP okay in hands/arms
but low in lower limbs.
*Bounding pulses in
upper body but weak in
lower.

Surgery: valve
replacements
and
catheterizations
*Prostaglandin
E1 to open
artery by
relaxing the
muscle.
*Diuretics and
inotropic drugs
to treat s/s
*Surgical Repair
*Catheterization

Always check
pulses both
sides and
upper and
lower
extremities!

Transpositio
n of the
Great
Arteries

Total
Anomalous
Pulmonary
Connection

Unoxygentated blood
enters the R. atrium and
R. Ventricle. Parallel
circulation.
*Initially appears normal
*Cyanosis develops w/in
a few hours of life

Prostiglandin
immediately to
keep PDA open.

*Cyanosis develops w/in


a few hours to a few
weeks of life depending
on configuration
*Tachypnea
*Dyspnea
*Snowman-figure 8
appearance on chest
xray
*R. Ventricular
hypertrophy
*Enlarged heart
*Murmurs

Surgery to
reconnect the
pulmonary
arteries to the
left atrium and
to close the
(ASD) atrial
septal defects

Surgery

This is NOT
compatible
with life. You
WANT another
defect to help.
Can be
detected by US
if they receive
prenatal care.

Sometimes
can be
detected in
utero via ultra
sound.

Truncus
Arteriosus

Hypoplastic
Left Heart
Syndrome

*Cyanosis develops w/in


a week or two of life
*CHF s/s
*Hazy chest x-ray
*Possible hepatomegaly
*Poor feeding
*Facial swelling or neck
vein distention

Left ventricle is tiny and


aortic stenosis is
present.
*O2 sats 70-80s
*Cyanosis
*Poor feeding
*Tachypnea
*Dyspnea
*Weak/rapid pulses
*Lethargy
*Cool/clammy skin
*Dilated
pupils/lackluster stare

Medicines such
as diuretics and
inotropic meds
to manage
signs/symptoms
.

Possibly not on
exam

Surgery:
separating the
pulmonary
arteries from
the truncus,
closure of the
septal defects,
create
connection from
pulmonary
arteries to the
right ventricle.
*Heart
Not compatible
transplant
with life
*3 step surgical
process (70-80%
survive; live in
the hospital)
*Do nothing

Pulmonary
Stenosis

Tetralogy of
Fallot

*Central cyanosis
*CHF s/s
*Possible Right-sided
hypertrophy
*Back up pressure can
open up Foreman Ovale

Prostiglandin
given to keep
PDA open

Combination of pulmonic
stenosis, right
ventricular hypertrophy,
overriding aorta and
VSD. Mixed blood is sent
out to system.
*Cyanosis
*O2 sats 80-85s
*Tachypnea
*Irritability

Treat symptoms:
-Decrease
venous return
-Conservative
O2
-Comfort and
stop crying to
minimize O2
consumption

Surgery:
Percutaneous
balloon
vulvuloplasty

Dont want to
put a lot of
oxygen on
them.
Squat knee to
chest to get
O2 by
restricting
venous return
and getting O2
to main
organs.
May be
associated
with
chromosomal
abnormalities