Alteration on Oxy (cardiac acyanotic) Cheat Sheet

by Dani (Dan_Niel) via cheatography.com/131883/cs/26611/

The Human Heart Atrial septal defect (Acyan​otic) (cont) Aortic Stenosis (Acyan​otic)

• Blood flows from left to right (oxy to deoxy) Narrowing at above or below the aortic
because of the stronger contra​ction of the valve.
left side of the heart, causing an increase Supr​ava​lvu​‐ ascending aorta. least
volume in the right. lar common
• Right atrium enlarged, ventri​cular hypert​‐ Valv​ular most common
rophy and increased pulmonary artery blood
Subv​alv​ular subaortic. left outflow tract.
flow.
Signs & Symptoms
Signs and symptoms
•Mild: exercise intole​rance, easy fatiga​bility,
•Dyspnea on exertion, fatiga​bility, mild
asymp.
growth failure
•Moderate: Chest pain, dyspnea, diziness &
•Cyanosis does not occur unless CHF is
syncope
present.
•Severe: weak pulses, left failure, hypote​‐
Diag​nosis
Risk Factors nsion, tachy and activity intole​rance chest
•ECG with color flow doppler reveal pain and sudden death.
• Cardiac develo​pment occurs very early in
enlarged right side of the heart
fetal life Trea​tment
• Cardiac cather​ization reveal separation in
• maternal factors (rubella, alcohol, diabetes •Balloon valvul​oplasty as the standard
atrial septum
mellitus) treatment
Trea​tme​nts
• Genetic factors (history of congenital heart •Mild: activity should not be restricted
•Surgical or cather​ization laboratory for
disease) •Mod-s​evere: no compet​itive sports
ASD2
• Trisomy 21 (Down syndrome) •Cardiac cathet​eri​zation: Balloon dilation
•Surgery : sutured, completed with cathet​‐
• Presence of other congenital anomalies or •Surgical valvotomy: if closed procedure
eri​zation
syndrome. doesn't work. done to older pts. when
•Cardi​opu​lmonary bypass : open heart
severe calcium deposits further obstruct the
surgery
Atrial septal defect (Acyan​otic) valve.
•Silastic or Dacron patch : sutured in place
Opening in the atrial septum permitting free •Beta blocker or calcium channel blocker
Comp​lic​ati​ons
commun​ication of blood between the 2 atria •Antib​iotic prophy​laxis against endoca​rditis
• Infectious endoca​rditis and eventual heart
Ostium primum (ASD1) open at lower end
failure
of septum
• can cause emboli during pregnancy if not
Ostium secundum (ASD2) open near the
treated
center septum
Path​oph​ysi​ology

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 Alteration on Oxy (cardiac acyanotic) Cheat Sheet
by Dani (Dan_Niel) via cheatography.com/131883/cs/26611/

Acyanotic (Conge​nital heart defect) Ventri​cular Septal Defect (Acyan​otic) Cyanotic (Conge​nital heart defect)
(cont)
Incr​eased pulmonary blood flow Decr​eased pulmonary blood flow
• Atrial septal defect •Sympt​omatic VSD: meds, afterload • Tetralogy of Fallot
reducers, diuretics
• Ventri​cular septal defect • Tricuspid atresia
•Moderate: cardiac cathet​eri​zation
• Patent ductus arteriosus Mixed blood flow
•Larger: 3mm open heart surgery
• Atriov​ent​ricular canal • Transp​osition of great vessels
•Excep​tio​nally large: Silastic or Dacron
Obst​ruction to blood flow from ventri​cles • Truncus arteriosus
patch
• Coarction of the aorta • Total anomalous pulmonary venous return
Comp​lic​ati​ons
• Aortic stenosis • Hypopl​astic left heart syndrome
• Cardiac or Heart failure
• Pulmonic stenosis
• Endoca​rditis due to recirc​ulating blood Atriov​ent​ricular Septal Defects (Acyan​‐
flow otic)
Diagnostic Tests
Indi​cation for surgery: Large vsd with •Also called an endo​cardial cushion
Echoca​rdi​ogram Cardiac Cathet​eri​‐
uncont​rolled sympto​mat​ology, Ages 6-12 defect, results from incomplete fusion of the
zation
mo. with large vsd & pulmonary HTN endoca​rdial cushion. At the septum of the
Electr​oca​rdi​‐ Chest X-ray
heart
ogram
Pulmonary Stenosis (Acyan​otic)
•Consists of a low atrial septal defect
Echoca​rdi​‐ MRI
Narrowing of the pulmonary valve or PA continuous with ventri​cular septal defect &
ography
that results in the obstru​ction of blood flow clefts of mitral & tricuspid, creating a large
from the ventri​cles. central AV valve
Ventri​cular Septal Defect (Acyan​otic)
Signs & Symptoms • Allows blood to flow between all heart
Abnormal opening in ventri​cular septum,
•Mild : Asympt​omatic, split 2nd heart sound chambers.
allows free commun​ication between R & L
w/ delay Signs and Symptoms
ventricles
•Heart failure (right) & cyanosis with severe •CHF in infancy, Failure to thrive, recurrent
Small to moderate VSD: 3-6 mm, asympt​‐
• Systolic ejection murmur, Right ventri​cular infections
omatic
enlarg​ement •Exercise intole​rance, easy fatiga​bility
Moderate to large VSD: sympto​matic,
require repair • Exercise intole​rance •Cardiac enlarg​ement on CX-ray

Signs & Symptoms 4-8 weeks Trea​tment •Late cyanosis from pulmonary vascular w/
•Mild: No interv​ention needed, close follow R to L shunt
•Easy fatigue, failure to thrive, dyspnea
up Trea​tment
• A loud, harsh murmur on left sternal
border (3rd/4th ) •Mid-s​evere: requires relieve of stenosis • Surgery is always required

• Thrill may be palpable, respir​atory •Balloon valvup​lasty, treatment of choice • Treatment of congestive symptoms.
infections •Surgical valvotomy is also a consid​era​tion. •Pulmonary banding maybe req. in
Trea​tment •Open-​heart needed only for more complex premature or <5kg

•Small VSD: no surgical interv​ention, just valve anomaly.

reassu​rance

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 Alteration on Oxy (cardiac acyanotic) Cheat Sheet
by Dani (Dan_Niel) via cheatography.com/131883/cs/26611/

Patent Ductus Arteriosus (Acyan​otic) Coarction of the Aorta (Acyan​otic)

Conduit between pulmonary artery & aorta fails Narrowing of aorta due to a constr​icting
to close and results in increased pul. blood flow band
(L to R shunt) Signs & Symptoms
Ductus Arteri​ousus fetal structure that •Dimin​ution or absence of femoral pulses
connects PA to the aorta. Closure at first breath
•Higher BP in upper extrem​ities,
and is incomplete bet. 7 to 14 days. closure not
headache, vertigo
until 3 mos.
•Weak lower extremity pulses. decrease
• blood will shunt from aorta (oxy) to the PA
cardiac output
(deoxy) because of the increased pressure in
• Epistaxis & CVA not in children due to
the aorta.
elevated BP
Signs & Symptoms
•Leg pain due to diminished blood supply
• Small PDA: usually asympt​omatic
Trea​tme​nts
• Large PDA: symptoms of CHF & growth restri​‐
•Surgical interv​ention, prevent left vent
ction
dysfun​ction
• Bounding arterial pulses, Widened pulse
•Angop​lasty is used by some centers
pressure
•Balloon angiop​lasty is the procedure of
• Enlarged heart, prominent apical impulse.
choice
•Classic continuous machinery systolic murmur
•Antih​ype​rte​nsive - High BP post-op
• Mild-d​ias​tolic murmur at the apex.
•Antib​iotic as prophy​lactic
Trea​tment
• Indome​thacin, inhibitor of prosta​glandin
synthesis
• Surgical or catheter closure.

Same compli​cations

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