CONGENITAL

HEART DISEASE
RIBOROSO, GRACIELLE RN
PALOD, CHRISTINE RN
 OBJECTIVE:
After the lecture, the participants will
be able:
•To know, understand and
comprehensively discuss, congenital
heart disease, and its medical and
nursing management
FETAL HEART CIRCULATION:
 WHAT IS CONGENITAL HEART
DISEASE
 Congenital heart disease (CHD) is a defect or problem with the
heart’s structure that’s present at birth, such as:
TYPES OF CONGENITAL HEART
DISEASE
Heart valve defects

Heart wall defects

Blood vessel defects

TYPES OF CONGENITAL HEART
DISEASE
CAUSES OF CONGENITAL
HEART DISEASE
 DIAGNOSIS OF
CONGENITAL HEART
DISEASE
 Nursing Management for CHD
 1. Assess heart rate and blood pressure
 2. Note skin color, temperature, and moisture.
 3. Check for peripheral pulses, including capillary
refill.
 4. Assess for reports of fatigue and reduced
activity tolerance.
 5. Inspect fluid balance and weight gain
 6. Assess heart sounds such as heart
murmurs.
 7. Monitor electrocardiogram
 Nursing Management for CHD
 8. Provide adequate rest periods
 9. Position the child in a semi-Fowler’s position.
 10. Administer oxygen therapy as prescribed.
 11. Administer medications as prescribed.
VENTRICULAR SEPTAL DEFECT
WHAT IS VENTRICULAR SEPTAL
DEFECT (VSD)?
 A ventricular septal defect (VSD) is
a birth defect of the heart in which
there is a hole in the wall (septum)
that separates the two lower
chambers (ventricles) of the heart.
 OCCURRENCE:
 Occurs in approximately 2-6 of every 1000 live
births and accounts for more than 20% of all
congenital heart diseases.
SIGNS AND SYMPTOMS:

• Shortness of breath,
• Fast or heavy breathing,
• Sweating,
• Tiredness while feeding, or
• Poor weight gain.
 MANAGEMENT:
 Surgical intervention (6-10 mm in diameter)
 Transcatheter device closure ( <6mm in diameter)
 Diuretics
ATRIAL SEPTAL DEFECT
WHAT IS ATRIAL SEPTAL DEFECT
(ASD)?

 An atrial septal defect is a birth

defect of the heart in which there is
a hole in the wall (septum) that
divides the upper chambers (atria)
of the heart.
 OCCURRENCE:
 Centers for Disease Control and
Prevention (CDC) estimated that
13 of every 10,000 babies born
had an atrial septal defect.
 ASD account for 7% of all
congenital heart defects.
 SIGNS AND SYMPTOMS:
• Frequent respiratory or lung
infections
• Difficulty breathing
• Tiring when feeding (infants)
• Shortness of breath when being
active or exercising
 SIGNS AND SYMPTOMS:
• Skipped heartbeats or a sense of
feeling the heartbeat
• A heart murmur, or a whooshing
sound that can be heard with a
stethoscope
• Swelling of legs, feet, or stomach
area
 MANAGEMENT:
 Surgical intervention
 Transcatheter device closure
 Betablockers
 Blood thinners
 Diuretics
 WHAT IS PATENT
DUCTUS ARTERIOSUS?
 A persistent opening between the
two major blood vessels leading
from the heart.
 OCCURRENCE:
 The reported incidence of PDA in term
neonates is only 1 in 2,000 births,
accounting for 5%–10% of all congenital
heart disease.
 The incidence of PDA in preterm
neonates is far greater, with reports
ranging from 20%–60%
 SIGNS AND SYMPTOMS:
• Cyanosis
• Very tired
• Fast or hard breathing
• Trouble feeding, or
tiredness while feeding
• Presence of recurrent infections(e.g
pneumonia)
• Poor weight gain
• In older children, trouble doing
activities
 MANAGEMENT:
 Surgical intervention
 Transcatheter device closure
 Indomethacin
 NSAIDs
WHAT IS PDA DEVICE CLOSURE?

 minimally-invasive (non-surgical)
procedure to close the ductus
arteriosus in which a small
mushroom like device is placed
EQUIPMENT USED FOR PATENT DUCTUS
ARTERIOSUS DEVICE CLOSURE
Patent Ductus Arteriosus Device Closure
HOW IS IT DONE?
PRE-PDAC POST-PDAC
MANAGEMENT:
PULMONARY
VALVE
STENOSIS
 WHAT IS PULMONARY
VALVE STENOSIS?
 Narrowing of the pulmonary valve
(valvar pulmonary stenosis) causes the
right ventricle to pump harder to get
blood past the blockage.
 INSERT VIDEO OF HEART SOUND
 OCCURRENCE:
 In children, pulmonary stenosis represents 8-12%
of all congenital heart defects.
 In adults, pulmonary stenosis represents
approximately 15% of all congenital heart defects.
 This condition accounts for almost 10 percent of
all congenital heart disease.
 SIGNS AND SYMPTOMS:
 Heart murmur
 Low tolerance for exercise
 Fatigue
 Fainting
 Shortness of breath
 Chest pain or palpitation
 SIGNS AND
SYMPTOMS:
 in newborns, cyanosis
 being very tired.
 poor weight gain.
 shortness of breath.
 SIGNS AND
SYMPTOMS:
 palpitations
 chest pain.
 fainting.
 a swollen abdomen.
 MANAGEMENT:

 Surgical intervention
 Balloon Angioplasty

 Post Operative Care
 Assess for bleeding, hematoma, cold clammy skin and edema of
punctured extremity.
 Apply pressured dressing on punctured site.
 Apply sandbag and light dressing after 4 hours of applying the
pressured dressing.
 Assess for vital signs religiously.
 Assess for signs of congestion.
 Monitor and record intake and output.