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Questions and Answers
The function of the heart is to pump blood only when the body is at rest.
The function of the heart is to pump blood only when the body is at rest.
False (B)
The umbilical vein carries oxygenated blood from the fetus to the placenta.
The umbilical vein carries oxygenated blood from the fetus to the placenta.
False (B)
Congenital heart diseases are present from birth and involve structural defects of the heart or great vessels.
Congenital heart diseases are present from birth and involve structural defects of the heart or great vessels.
True (A)
Tachycardia is a clinical manifestation that can be observed in children with heart disease.
Tachycardia is a clinical manifestation that can be observed in children with heart disease.
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The Ductus Arteriosus shunts blood between the pulmonary artery and the aorta.
The Ductus Arteriosus shunts blood between the pulmonary artery and the aorta.
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In preterm infants, the Patent Ductus Arteriosus (PDA) is caused by congenital heart disease.
In preterm infants, the Patent Ductus Arteriosus (PDA) is caused by congenital heart disease.
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A continuous machinery murmur heard beneath the left clavicle is a physical finding associated with Patent Ductus Arteriosus.
A continuous machinery murmur heard beneath the left clavicle is a physical finding associated with Patent Ductus Arteriosus.
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Coarctation of the aorta results in elevated blood pressure in the lower extremities compared to the upper extremities.
Coarctation of the aorta results in elevated blood pressure in the lower extremities compared to the upper extremities.
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Balloon angioplasty via cardiac catheterization is the preferred procedure for managing pulmonary stenosis.
Balloon angioplasty via cardiac catheterization is the preferred procedure for managing pulmonary stenosis.
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Congestive heart failure is one of the complications that may arise from a Patent Ductus Arteriosus.
Congestive heart failure is one of the complications that may arise from a Patent Ductus Arteriosus.
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The incidence of congenital heart defects (CHDs) ranges from 5 to 8 per 1000 births.
The incidence of congenital heart defects (CHDs) ranges from 5 to 8 per 1000 births.
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More than 90% of CHD cases have a known genetic cause.
More than 90% of CHD cases have a known genetic cause.
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Ventricular Septal Defect (VSD) is classified as a cyanotic congenital heart defect.
Ventricular Septal Defect (VSD) is classified as a cyanotic congenital heart defect.
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Maternal factors such as age over 40 years can increase the incidence of CHDs.
Maternal factors such as age over 40 years can increase the incidence of CHDs.
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Tachypnea is often the first presenting symptom of Ventricular Septal Defect (VSD).
Tachypnea is often the first presenting symptom of Ventricular Septal Defect (VSD).
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Atrial Septal Defects (ASD) usually close spontaneously by the age of 10 years.
Atrial Septal Defects (ASD) usually close spontaneously by the age of 10 years.
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Diuretics and digoxin are used as the initial treatment for managing heart failure in patients with congenital heart defects.
Diuretics and digoxin are used as the initial treatment for managing heart failure in patients with congenital heart defects.
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Pulmonary stenosis is an example of a left-to-right shunt defect in congenital heart disease.
Pulmonary stenosis is an example of a left-to-right shunt defect in congenital heart disease.
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Study Notes
Cardiovascular Disorders in Pediatrics
- Prepared by SAFA MOHAMMED ABDEBAGI
- MSc: Pediatric Nursing – University of Gezira
- Bachelor: Nursing Sciences – Alneelain University
- Email: [email protected]
Learning Objectives
- Describe the structure and function of the heart.
- Describe fetal circulation.
- Discuss general assessment of a child with heart disease.
- Discuss congenital heart disease.
Heart Function
- The heart pumps blood in sufficient amounts to meet the body's needs.
Fetal Circulation
- Umbilical vein: Carries oxygenated blood from the placenta to the fetus.
- Umbilical arteries: Carry deoxygenated blood from the fetus to the placenta.
- Foramen ovale: A septal opening between the fetal atria.
- Ductus venosus: Carries oxygenated blood from the umbilical vein to the inferior vena cava (IVC).
- Ductus arteriosus: A shunt between the pulmonary artery and the aorta.
General Assessment (History)
- Health history of the child (including familial history of genetic diseases).
- Maternal health.
- Birth or neonatal health.
Clinical Manifestations
- Weak cry
- Respiratory distress
- Tachycardia
- Decreased tolerance for exercise
- Edema
- Tendency to assume a squatting position
Diagnostics
- ECG (Electrocardiogram)
- X-Ray
- Echo (Echocardiogram)
- Laboratory: Platelets, Electrolytes, and cardiac enzymes
- Physical assessment: - Vital signs - Physical examination - Observation of activity - Pulse area - Edema - Abdominal organs - Skin for capillary refill - Heart sounds
Types of Heart Disease
- Congenital heart diseases
- Acquired heart diseases
Congenital Heart Diseases (CHDs)
- Structural defects of the heart, great vessels, or both, present from birth.
- Incidence: 5 to 8 per 1000 births.
- Etiology: Unknown in over 90% of cases. Factors linked to increased incidence include maternal infection, diabetes, alcoholism, age over 40, exposure to radiation, and genetic factors.
Classification of CHDs
- Acyanotic: Left-to-right shunts (e.g., Ventricular Septal Defect (VSD), Atrial Septal Defect, Patent Ductus Arteriosus (PDA))
- Cyanotic: Outflow obstruction (e.g., Tetralogy of Fallot, transposition of the great arteries)
Ventricular Septal Defect (VSD)
- Most common CHD.
- Abnormal opening between the right and left ventricles
- Common: 25-30% of CHD cases.
Atrial Septal Defect (ASD)
- Abnormal communication between the two atria.
- Pressure higher in the left atrium than right, causing blood to shunt from left to right.
- Right atrium and pulmonary artery enlarge due to increased blood flow.
Patent Ductus Arteriosus (PDA)
- Ductus arteriosus fails to close after birth.
- Allows blood flow from the pulmonary artery to the aorta.
- Often seen in preterm infants due to prematurity.
- Physical finding: Continuous machinery murmur beneath the left clavicle.
Management of CHDs
- VSD: Initial treatment - diuretics and digoxin, followed by surgical closure usually between 3-6 months of age if poor growth continues.
- ASD: Medication (digoxin), cardiac catheterization, and open heart surgery.
- PDA: Medication (e.g., Indomethacin), cardiac catheterization, and surgery.
- Coarctation of Aorta: Medical management with medication (prostaglandin), balloon valvuloplasty, and surgical repair to improve ventricular function and restore blood flow to the lower body.
Complications
- Endocarditis
- Congestive heart failure
- Aortic rupture
Pulmonary Stenosis
- Narrowing of the pulmonary valve or pulmonary artery.
- Management: Management depends on the severity and child's age, balloon angioplasty by way of cardiac catheterization often the initial choice of treatment.
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Description
This quiz covers essential concepts related to cardiovascular disorders in pediatric patients. Topics include the structure and function of the heart, fetal circulation, and assessments for heart disease in children. Gain insights into congenital heart conditions and how to evaluate their impact on pediatric health.
